Title: Ischemic preconditioning enhances donor lung preservation in the rabbit
Authors: Gasparri, Roberto ×
Jannis, Nicole
Flameng, Willem
Lerut, Antoon
Van Raemdonck, Dirk #
Issue Date: 1999
Series Title: European Journal of Cardio-Thoracic Surgery vol:16 issue:6 pages:639-46
Abstract: OBJECTIVE: Ischemic preconditioning achieved by brief periods of ischemia followed by reperfusion before a prolonged period of ischemia, is well known to reduce myocardial damage. We investigated whether ischemic preconditioning of the lung could also attenuate ischemia-reperfusion injury following pulmonary preservation. METHODS: Transient ischemia of the right lung was achieved in rabbits (n = 4 in each group) by occluding the main bronchus and pulmonary artery, followed by reperfusion according to a protocol that differed between study groups: group 1 (control), 45 min ventilation; group 2, 30 min ventilation, 5 min ischemia and 10 min reperfusion; group 3, three periods of 5 min ischemia and 10 min reperfusion; group 4, five periods of 3 min ischemia and 6 min reperfusion. Donor lungs were then flushed with a crystalloid solution followed by inflated storage at 37 degrees C for 2 h. The function of the right lung was assessed during reperfusion for 2 h with homologous, diluted and deoxygenated blood in an isolated, pressure-limited, and room-air ventilated model. RESULTS: Significant differences (P < 0.0001) were observed between groups 1 and 2 vs. groups 3 and 4 in veno-arterial oxygen pressure gradient (29 +/- 6 and 24 +/- 6 mmHg vs. 124 +/- 24 and 132 +/- 14 mmHg, respectively), and in weight gain (88 +/- 13 and 98 +/- 13% vs. 44 +/- 9 and 29 +/- 3%, respectively) after 1 h of reperfusion, and in wet-to-dry weight ratio (15.5 +/- 1.5 and 14.3 +/- 0.4 vs. 10.1 +/- 1.6 and 9.0 +/- 0.8, respectively) at the end of reperfusion. No significant differences in any of these parameters were observed between group 1 vs. group 2 neither between group 3 vs. group 4. CONCLUSIONS: These data suggest: (1) That 15 min, but not 5 min of transient ischemia prior to pulmonary preservation can significantly reduce edema in the lung graft upon reperfusion, thus improving oxygenation capacity and (2) although not significant, this beneficial effect seems to be slightly better with more repetitive periods of transient ischemia. Further research is warranted to investigate whether ischemic preconditioning in the human organ donor may become a new strategy to protect lung tissue during a planned ischemic event as in pulmonary transplantation.
ISSN: 1010-7940
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Thoracic Surgery
Experimental Cardiac Surgery
Surgery - miscellaneous (-)
× corresponding author
# (joint) last author

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