The role of dextran 40 and potassium in extended hypothermic lung preservation for transplantation

• Autor: Keshavjee, S.H. ; Yamazaki, F. ; Yokomise, H. ; Cardoso, P.F. ; Mullen, J.B.M. ; Slutsky, A.S. ; Patterson, G.A.
• Assuntos: Animals ; Biological and medical sciences ; Bronchi - pathology ; Bronchi - transplantation ; Cardiac & Cardiovascular Systems ; Cardiovascular System & Cardiology ; Dextrans ; Dogs ; Hemodynamics ; Life Sciences & Biomedicine ; Lung - pathology ; Lung Transplantation ; Medical sciences ; Organ Preservation ; Potassium ; Pulmonary Circulation ; Respiratory System ; Science & Technology ; Solutions ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the respiratory system
• É parte de: The Journal of thoracic and cardiovascular surgery, 1992-02, Vol.103 (2), p.314-325
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• Descrição: We have previously demonstrated that a low-potassium dextran solution provides superior and more reliable preservation of lungs for 12 hours than that provided by the commonly used Euro-Collins solution. This study was designed to examine the individual contributions of dextran 40 and a low (extracellular) potassium concentration to lung preservation. In a randomized, blinded study using an in vivo canine single-lung transplant model, lungs preserved with low-potassium dextran solution (K+, 4 mmol/L; dextran 40, 20 gm/L) were compared to lungs preserved with low-potassium, no-dextran solution (K+, 4 mmol/L) and high-potassium dextran solution (K+, 123 mmol/L; dextran 40, 20 gm/L). The lungs were assessed immediately and 3 days after transplantation. The low-potassium dextran solution provided excellent immediate pulmonary function with little variability (arterial oxygen tension, 519 ± 12 mm Hg, measured on the transplanted lung alone, inspired oxygen fraction = 1.0, n = 6). Removing the dextran 40 from the flush solution (low-potassium group) led to a significant deterioration in pulmonary function (arterial oxygen tension, 243 ± 78 mm Hg, n = 6, p < 0.01). The high-potassium dextran solution provided extremely poor preservation (arterial oxygen tension, 176 ± 79 mm Hg; n = 6; p < 0.01). Two animals in this group died within 6 hours of operation. Viability of the transplanted bronchus was significantly improved with the two solutions containing dextran 40. These results indicate that dextran 40 and low potassium concentration both contribute significantly to the uniformly excellent 12-hour lung preservation seen with the low-potassium dextran solution. (J Thorac Cardiovasc Surg 1992;103:314—25)
  
• Editor: NEW YORK: Elsevier Inc
  
• Idioma: Inglês