Beneficial effect of iloprost on early pulmonary function after lung preservation with modified eurocollins solution

Prostacyclin (PGI2) has proven beneficial effects on organ preservation. Iloprost (ZK 36 374), a stable synthetic analogue with a longer half-life of 14 minutes is reported to have less hypotensive effects than PGI2 while offering increased cytoprotective and antiaggregation action. In this study its effects on lung-preservation were investigated. The heart lung block of 12 Beagle dogs was harvested after flushing of the pulmonary artery with 60 ml/kg modified Eurocollins (MEC) solution, the left lung was stored for 4 hours and then transplanted into 12 weight-matched dogs. Prior to operation the animals were randomized into two groups with MEC solution as the only preservative in group A and an additional i.v. infusion of 1 microgram/kg/min Iloprost during 15 minutes prior to flushing and 15 micrograms/kg Iloprost administered to the perfusate in group B. Arterial pO2, alveolo-arterial oxygen difference (AaDO2) and pulmonary artery pressure (PAP) of the transplanted lungs were measured 1, 4, 12, and 24 hours after transplantation during occlusion of the contralateral pulmonal artery. The application of Iloprost resulted in a significant improvement of pO2 (p = 0.047), AaDO2 (p = 0.002) and PAP (p = 0.018) after 1 hour. Results in group B at later time points were improved without reaching statistical significance. Iloprost therefore showed beneficial effects on pulmonary function early after lung preservation with MEC.