Beneficial effects of leukocyte-depleted blood and low-potassium dextran solutions on microvascular permeability in preserved porcine lung

Am J Respir Crit Care Med. 1999 Aug;160(2):689-97. doi: 10.1164/ajrccm.160.2.9809029.

Abstract

Modified Euro-Collins (EC) solution, a crystalloid intracellular-type solution, has been commonly used for pulmonary preservation. Several experimental studies have shown the advantages of using extracellular colloid-based solutions. The aim of this study was to compare the quality of preservation of two extracellular colloid solutions, leukocyte-depleted blood (BL) and low-potassium dextran (LPD) solutions, with that of EC solution. Lungs of 22 domestic pigs were flushed and preserved with EC (n = 8), BL (n = 7), or LPD (n = 7) solution. After harvesting, one of the lungs was reperfused immediately in an ex vivo circuit (control lungs), whereas the contralateral lung was reperfused after 8 h of cold (4 degrees C) storage (preserved lungs). Besides the lung function parameters (gas exchange, pulmonary hemodynamics and mechanics), the permeability of the endothelial-epithelial barrier was assessed by determining the transferrin leak index (TLI) using a double radioisotopic method, by measuring the alveolar/arterial protein concentration ratio, and by analyzing histopathologic changes. The functional quality (oxygenation, airway resistance, dynamic compliance [CL, dyn]) of both BL and LPD lungs was slightly but significantly superior to that of EC lungs. However, pulmonary vascular resistance was lower in BL-preserved than in EC- or LPD-preserved lungs. The TLI was increased in EC control and preserved lungs, whereas it was low in BL and LPD control lungs and did not increase after preservation. The alveolar/arterial protein concentration ratio was not different between control groups, but was increased fourfold in EC-preserved compared with BL- or LPD-preserved lungs. Finally, EC-preserved lungs presented a weight gain about twice that of BL- and LPD-preserved lungs. Morphologic analysis confirmed these results, because in the EC-preserved lungs, rupture of alveolar septa and severe alveolar edema and hemorrhage were observed, whereas BL- and LPD-preserved lungs showed a relatively well-preserved structure. The results demonstrate that both BL and LPD flush solutions preserve the endothelial-epithelial barrier better than does EC solution. Although the quality of preservation is similar, pulmonary vascular resistance is higher in LPD-preserved than in BL-preserved lungs.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Blood*
  • Capillary Permeability / drug effects
  • Capillary Permeability / physiology
  • Dextrans / pharmacology*
  • Female
  • Hypertonic Solutions / pharmacology
  • Lung / drug effects
  • Lung / pathology
  • Lung / physiopathology
  • Lung Compliance / physiology
  • Lung Transplantation / pathology
  • Lung Transplantation / physiology*
  • Lung Volume Measurements
  • Lymphocyte Depletion*
  • Male
  • Organ Preservation Solutions / pharmacology*
  • Organ Preservation*
  • Oxygen / blood
  • Potassium / pharmacology*
  • Reperfusion Injury / pathology
  • Reperfusion Injury / physiopathology
  • Respiratory Mechanics / physiology
  • Swine

Substances

  • Dextrans
  • Euro-Collins' solution
  • Hypertonic Solutions
  • Organ Preservation Solutions
  • Potassium
  • Oxygen