L-arginine and pentoxifylline attenuate endothelial dysfunction after lung reperfusion injury in the rabbit. The Paris-Sud University Lung Transplant Group

Ann Thorac Surg. 1995 Sep;60(3):646-50. doi: 10.1016/0003-4975(95)00484-3.


Background: Among the factors involved in the early complications of lung transplantation is the ischemia-reperfusion syndrome related to a warm reperfusion in ischemic lungs.

Methods: Using an isolated rabbit lung preparation perfused with whole blood, we studied the effects of cold ischemia followed by a warm reperfusion on pulmonary vascular responses to reproduce experimentally the conditions encountered during lung transplantation.

Results: Pulmonary vascular responses to acetylcholine were rapidly altered by warm ischemia (relaxation of 7% versus 60% in controls). Conversely, relaxation was maintained even after a prolonged cold ischemic storage (maximal relaxation of 57% at 48 hours). Warm reperfusion in ischemic lungs induced major alteration of endothelium-dependent relaxation (maximal relaxation of 13% at 4 hours). The addition of L-arginine or pentoxifylline during reperfusion prevented the pulmonary endothelial alteration resulting from warm reperfusion.

Conclusion: These data suggest that treatments aimed at maintaining intact functional endothelium reduce ischemia-reperfusion injury in transplanted lungs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetylcholine / pharmacology
  • Animals
  • Arginine / therapeutic use*
  • Blood
  • Cardiopulmonary Bypass / adverse effects
  • Cold Temperature
  • Endothelium, Vascular / drug effects*
  • Endothelium, Vascular / injuries
  • Ischemia / physiopathology
  • Lung / blood supply*
  • Lung / drug effects
  • Lung Injury
  • Lung Transplantation / adverse effects*
  • Muscle, Smooth, Vascular / drug effects
  • Muscle, Smooth, Vascular / injuries
  • Pentoxifylline / therapeutic use*
  • Pulmonary Artery / drug effects
  • Pulmonary Artery / physiopathology
  • Rabbits
  • Reperfusion Injury / prevention & control*
  • Reproducibility of Results
  • Vasoconstriction / drug effects
  • Vasodilation / drug effects


  • Arginine
  • Acetylcholine
  • Pentoxifylline