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Inhaled nitric oxide at the time of harvest improves early lung allograft function
S Fujino1, I Nagahiro, A N Triantafillou
1Department of Surgery, Washington University School of Medicine, Barnes Hospital, St. Louis, Missouri, USA.
The Annals of Thoracic Surgery
|May 1, 1997
Summary
Inhaled nitric oxide (NO) given at harvest improved canine lung allograft function by reducing storage-related injury and neutrophil sequestration, leading to better oxygenation post-transplant.
Area of Science:
- Transplantation immunology
- Pulmonary medicine
- Biomedical engineering
Background:
- Inhaled nitric oxide (NO) shows promise in treating acute lung injuries.
- Lung allograft reperfusion injury is a significant post-transplant complication.
Purpose of the Study:
- To evaluate the impact of inhaled NO during harvest on canine lung allograft function.
- To assess NO's effect on allograft preservation and early post-transplant performance.
Main Methods:
- Left lung allotransplantation in ten dogs.
- Donor lungs flushed and stored for 21 hours.
- Inhaled NO (60 ppm) administered to donor animals (Group II) at harvest, while controls (Group I) received no NO.
- Assessment of hemodynamics, blood gases, myeloperoxidase activity, and wet/dry weight ratio for 6 hours post-transplant.
Main Results:
- Group II showed reduced pulmonary vascular resistance and thiobarbituric acid-reactive materials, indicating less oxidant injury.
- Superior oxygenation was observed in Group II (169.1 mmHg) compared to Group I (88.9 mmHg) at 6 hours.
- Significantly lower myeloperoxidase activity and wet/dry weight ratio in Group II suggest reduced neutrophil sequestration and edema.
Conclusions:
- Inhaled NO at harvest enhances early lung allograft function.
- NO attenuates oxidant injury during storage and reduces post-transplant neutrophil sequestration.
- This intervention improves graft preservation and early functional outcomes.