Twenty-four hour lung preservation by hypothermia and leukocyte depletion

In lung preservation, as well as in other forms of pulmonary disease, injury is associated with sequestration of leukocytes. We hypothesized that leukocyte depletion could prevent reperfusion injury and prolong the period of safe lung preservation. The heart-lung block from 39 New Zealand white rabbits were harvested, flushed with 100 ml of a modified Collins solution, stored at 4 degrees C in a 30% inflation state, and reperfused with either whole blood or leukocyte depleted blood. Leukocyte depletion was accomplished using a blood filter and verified with selected leukocyte counts. Leukocyte readdition specimens were obtained from whole blood, the separation being done with hydroxyethyl starch and centrifugation at 4,000 rpm for five minutes. Six groups of rabbit lungs were studied. Group 1 consisted of control lungs that were not preserved and were reperfused with whole blood. Lungs in Group 2 underwent five-hour preservation and whole blood reperfusion. Lungs in Group 3 underwent five-hour preservation and leukocyte depleted blood reperfusion. Lungs in Group 4 underwent 24-hour preservation and leukocyte depleted blood reperfusion. Lungs in Group 5 also underwent 24-hour preservation, leukocyte depleted blood reperfusion, but with leukocyte readded at the onset of reperfusion. Lastly, lungs in Group 6 underwent 24-hour preservation, leukocyte depleted blood reperfusion, with leukocyte readdition after one hour of reperfusion. Group 5 showed pulmonary edema and complete reservoir emptying within the first hour of reperfusion. Group 2 had comparable poor results. Groups 3, 4, and 6 showed no significant differences from the control lungs in regard to pressure or reservoir loss.(ABSTRACT TRUNCATED AT 250 WORDS)