Source: Annual Congress 2012 - Lung transplantation: studies in candidates and recipients
Disease area: Pulmonary vascular diseases, Respiratory critical care

Abstract

Introduction: By using an ex vivo model of isolated perfused and ventilated rabbit lungs we investigated the influence of systemic oxygenation on pulmonary function during simulated transplantation.
Methods: Lungs of New Zealand White rabbits were flush-perfused with Perfadex® Solution, followed by an ischemic storage for 4h on ice. Thereafter ventilation and reperfusion for 2h were continued to simulate a transplantation situation (oxygenated group, pulmonary artery pO₂=120mmHg). In another series the perfusate inflow was gassed with nitrogen to simulate the typical situation with deoxygenated pulmonary artery blood and not reanastomized private vessels(deoxygenated group, pulmonary artery pO₂=50mmHg). Hemodynamic and ventilatory parameters were continuously detected.
Results: After 2h reperfusion time the oxygenated group showed a significant lower PAP and lung weight compared to the deoxygenated group (p<0.05). PAP and lung weight steadily increased after reestablishment of lung perfusion (PAP 8.78±0.89 to 11.5±1.06cmH₂O; lung weight 22.1±1.32 to 35.4±4.23g). This development was significantly influenced by the intravascular pO₂ (PAP 9.65±0.43 to 8.02±0.63cmH₂O; lung weight 17.9±1.54 to 21.5±2.29g, p<0.05).
Conclusions: Oxygenation of the lung perfusate during simulated transplantation attenuates post transplant edema formation and decreases pulmonal arterial hypertension. Transfering this to the surgical situation, revascularisation of bronchial arteries after lung transplantation might initiate positive effects in the early phase after lung transplantation.

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Citations should be made in the following way:
S. Klein, S. Dhein, L. Bauer, F. Schlegel, S. Lehmann, M. Barten, F.W. Mohr, H. Bittner (Leipzig, Germany). Systemic oxygenation affects post-transplantation edema formation and pulmonary artery hypertension in an ex vivo animal model. Eur Respir J 2012; 40: Suppl. 56, 1482

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