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Preharvest nitroprusside flush improves posttransplantation lung function

S Fujino1, I Nagahiro, M Yamashita

  • 1Department of Surgery, Washington University School of Medicine, Barnes Hospital, St. Louis, Mo., USA.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|November 15, 1997
PubMed
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Nitroprusside (NP) reduces lung allograft reperfusion injury. Administering NP in the flush solution effectively improves gas exchange and reduces neutrophil sequestration, offering a practical clinical approach.

Area of Science:

  • Cardiovascular Surgery
  • Transplantation Immunology
  • Pulmonary Medicine

Background:

  • Early allograft dysfunction is a major challenge in lung transplantation.
  • Nitroprusside (NP), a nitric oxide donor, previously showed promise in reducing lung reperfusion injury.
  • This study aimed to differentiate storage versus reperfusion effects of NP.

Purpose of the Study:

  • To determine if nitroprusside (NP) administration during storage or reperfusion reduces lung allograft injury.
  • To assess the specific contributions of storage and reperfusion phases to NP's protective effects.
  • To evaluate the clinical practicality of different NP administration strategies.

Main Methods:

  • Fifteen canine left lung allotransplants were performed.

Related Experiment Videos

  • Donor lungs were flushed and stored for 21 hours.
  • Nitroprusside (NP) was administered either in the flush solution (Group II) or to the recipient during reperfusion (Group III), compared to no NP (Group I).
  • Allograft function, hemodynamics, gas exchange, myeloperoxidase (MPO) activity, and wet/dry weight ratio were assessed.

    • Main Results:

    • Both NP administration methods significantly improved gas exchange (PaO2) compared to controls.
    • Myeloperoxidase activity and wet/dry weight ratio were significantly reduced in NP-treated groups, indicating less neutrophil sequestration and edema.
    • Recipient NP administration lowered systemic vascular resistance.

    Conclusions:

    • Nitroprusside (NP) administration, whether in flush solution or to the recipient, effectively reduces lung allograft reperfusion injury.
    • NP in the flush solution is a practical and effective method for reducing lung reperfusion injury in clinical settings.
    • Recipient NP administration is associated with decreased systemic vascular resistance.