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Titolo:
EXOGENOUS SURFACTANT THERAPY IN 38-HOUR LUNG GRAFT PRESERVATION FOR TRANSPLANTATION
Autore:
NOVICK RJ; VELDHUIZEN RAW; POSSMAYER F; LEE J; SANDLER D; LEWIS JF;
Indirizzi:
UNIV WESTERN ONTARIO HOSP,DIV CARDIOVASC THORAC SURG,POB 5339 LONDON N6A 5A5 ON CANADA ROBARTS RES INST LONDON ON CANADA ST JOSEPHS HLTH CTR,DEPT MED,DIV RESPIROL LONDON ON CANADA UNIV WESTERN ONTARIO,DEPT BIOCHEM LONDON ON CANADA UNIV WESTERN ONTARIO,DEPT OBSTET & GYNAECOL LONDON ON CANADA UNIV WESTERN ONTARIO,MRC,FETAL & NEONATAL HLTH & DEV GRP LONDON ON CANADA
Titolo Testata:
Journal of thoracic and cardiovascular surgery
fascicolo: 2, volume: 108, anno: 1994,
pagine: 259 - 268
SICI:
0022-5223(1994)108:2<259:ESTI3L>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
RESPIRATORY-DISTRESS SYNDROME; TUMOR-NECROSIS-FACTOR; PULMONARY SURFACTANT; II CELLS; SECRETION; PHOSPHOLIPIDS; METABOLISM; FAILURE; RABBITS; INJURY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
31
Recensione:
Indirizzi per estratti:
Citazione:
R.J. Novick et al., "EXOGENOUS SURFACTANT THERAPY IN 38-HOUR LUNG GRAFT PRESERVATION FOR TRANSPLANTATION", Journal of thoracic and cardiovascular surgery, 108(2), 1994, pp. 259-268

Abstract

Previous work in our laboratory has documented alterations in surfactant composition and function after prolonged lung graft storage and transplantation in dogs (Am Rev Respir Dis 1993;148:208-15). To determine whether exogenous surfactant therapy was beneficial, we pretreated 13 canine double lung blocks with prostacyclin, flushed them with 4 degrees C modified Euro-Collins solution, and stored them at 4 degrees C for 37 to 38 hours. After left lung transplantation and immediately before reperfusion, eight dogs were administered 50 mg of bovine lung lipid extract surfactant per kilogram (50 mg/ml) directly into the left main bronchus and five Served as nontreated control animals. Blood gases, peak inspired pressures, and individual pulmonary artery blood flows were measured every 30 minutes during 6 hours of reperfusion. The native right and transplanted left lungs were then lavaged and surfactant large and small aggregates and protein yields were analyzed. All nontreated animals had physiologic evidence of severe ischemia-reperfusion lung injury during reperfusion. Three of eight dogs treated with bovine lung lipid extract surfactant had near normal lung function at 6 hours of reperfusion, as reflected by maintenance of an oxygen tension/inspired oxygen fraction ratio of more than 400 mm Hg and a normal carbon dioxide tension. Five of eight dogs did not respond to surfactanttherapy and had decreases in gas exchange identical to those of the control animals. Blood flow through the left pulmonary artery was maintained in the three animals that responded to exogenous surfactant, whereas flow significantly decreased to the left lung in all other animals, reflecting the patterns of gas exchange. In addition, the ratio of poorly functioning small surfactant aggregates to the well-functioninglarge aggregates isolated from lung lavage after 6 hours of reperfusion was decreased in surfactant-treated animals, especially in those exhibiting a beneficial physiologic response to surfactant therapy. We conclude that therapy with bovine lung lipid extract surfactant can result in excellent preservation of lung grafts after prolonged storage and transplantation, but that the results are not consistent, Further investigations are required to determine the factors responsible for the differential response to surfactant therapy.

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Documento generato il 16/07/20 alle ore 06:20:16