High potassium contents in organ preservation solutions cause strong pulmonary vasocontraction

Kimblad, Per Ola; Sjöberg, Trygve; Massa, G; Solem, Jan Otto; Steen, Stig

doi:10.1016/0003-4975(91)90917-f

Cited by 69 publications

(27 citation statements)

References 14 publications

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“…Since it has been shown that Euro-Collins solution did not induce significant pulmonary vasoconstriction at 6°C [5], there would be a reasonable rationale in using organ preservation solutions at low temperatures for pulmonary vascular flushing. However, little is known about the impact of temperature on the contractile profile of pulmonary vessels.…”

Section: Introductionmentioning

confidence: 99%

Difference in the Effects of Low Temperatures on the Tension of Human Pulmonary Artery and Vein Ring Segments

Suzuki

Sugita²,

Ono³

et al. 2000

Respiration

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Background: Although limited data suggest that pulmonary flushing with organ preservation solutions should not be performed at too low temperatures, the influence of temperature on pulmonary vascular tone is unclear. Objective: The purpose of this study was to examine the effect of low temperatures of the tension of human pulmonary artery and vein ring segments and the vascular resistance of perfused rat lungs. Methods: 5 sets of human pulmonary artery and vein ring segments were suspended from a force displacement transducer at 37, 24 and 8°C, and the effect of 30 mM K⁺ on the tension was monitored. The effect of 30 mM K⁺ on vascular resistance was also examined at low temperatures in 5 perfused rat lungs. Results: Pulmonary artery segments dilated at 24°C, and more significant vasodilatation was observed at 8°C. In contrast, there was a significant constriction of pulmonary veins at 8°C. Vasoconstriction induced by 30 mM K⁺ at 37°C was significantly inhibited at low temperatures in both pulmonary arteries and veins. In rat lungs, perfusion at 8°C caused a significant increase in pulmonary vascular resistance, even though no further increase was observed in the presence of 30 mM K⁺. Conclusions: Our data indicate that pulmonary arteries dilate and the veins constrict at 8°C and may increase pulmonary vascular resistance. We conclude that the different effect of low temperatures between pulmonary arteries and veins may explain why pulmonary vascular flushing with organ preservation solutions at room temperature is more satisfactory.

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Section: Introductionmentioning

confidence: 99%

Difference in the Effects of Low Temperatures on the Tension of Human Pulmonary Artery and Vein Ring Segments

Suzuki

Sugita²,

Ono³

et al. 2000

Respiration

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“…PGE 1 did not reduce resting pulmonary vascular tone in organ donors, which is typical of all pulmonary vasodilators. In our previous work, PGE 1 in pulmonary flush solution did not prevent increase in PVR after lung transplantation [6]. The present experiment shows that an earlier administration of PGE 1 is not more efficient in this respect.…”

Section: Discussionmentioning

confidence: 76%

“…The high potassium content of ECS causes strong pulmonary vasoconstriction in experimental animals [1][2][3]. Prostaglandin E 1 (PGE 1 ) has been 430 Eur Surg Res 1999;31:429- 436 Vainikka/Heikkilä/Kukkonen/ Toivonen/Verkkala/Mattila used in donor pretreatment to counteract this vasoconstriction, and to improve the distribution of the lung perfusate.…”

Section: Introductionmentioning

confidence: 99%

Donor Lung Pretreatment with Prostaglandin E<sub>1</sub> Does Not Improve Lung Graft Preservation

Vainikka

Heikkilä²,

Kukkonen³

et al. 1999

Eur Surg Res

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Prostaglandin E₁ (PGE₁) is widely used to improve early graft function after lung transplantation, but some studies have questioned its benefits. Therefore we evaluated the effect of donor pretreatment with PGE₁ in our porcine model of single lung transplantation. Donors received PGE₁ or placebo intravenously before flushing the pulmonary artery with modified Euro-Collins solution. After cold storage, the excised left lung was transplanted. Ischemic time was 4 h. We used our right side heart bypass model to measure standardized pulmonary vascular resistance and to study blood flow distribution between recipient’s native and transplanted lung. Systemic and pulmonary hemodynamics and gas exchange were also measured. After transplantation, pulmonary vascular resistance was significantly higher in the transplanted lung, which received only one fourth of the total pulmonary blood flow. PGE₁ pretreatment did not improve pulmonary hemodynamic parameters, or gas exchange.

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“…As pathophysiological rationale for the development of an ischemia-reperfusion injury by use of EuroCollins solution, a direct effect of the high-potassium content of Euro-Collins on endothelial cells of the pulmonary vasculature has been discussed [6]. An observed increase of the pulmonary vascular resistance during reperfusion seemed to be caused by a reduction of endothelial NO synthesis, which by means of reduction of the vascular relaxation capacity may lead to an increase of their resistance [7,14].…”

Section: Discussionmentioning

confidence: 99%

“…As major pathogenetic factor the high potassium content of the Euro-Collins solution has been discussed, which induces a strong vasoconstriction of the pulmonary vessel bed [6] and reduces the vascular relaxation capacity of pulmonary vessels [7].…”

Section: Introductionmentioning

confidence: 99%

Improvement of Lung Preservation – From Experiment to Clinical Practice

Müller

Bittmann²,

Hatz³

et al. 2002

Eur Surg Res

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Background: Reperfusion injury represents a severe early complication following lung transplantation. Among the pathogenetic factors, the high potassium content of Euro-Collins^® solution is discussed. Material and Methods: In a pig model of orthotopic left-sided lung transplantation we investigated the effect of Euro-Collins solution (EC: n = 6) versus low potassium dextran (LPD: Perfadex^®: n = 6). Sham-operated (n = 6) animals served as control. Transplant function, cellular energy metabolism and endothelial morphology served as parameters. In a clinical investigation, 124 patients were evaluated following single (EC: n = 31; LPD n = 37) or double (EC: n = 17; LPD n = 39) lung transplantation, whose organs where preserved with EC (n = 48) or LPD (n = 76). Duration of ischemia, duration of ventilation and stay on ICU were registered. Primary transplant function was evaluated according to AaDO₂ values. Cause of early death (30 days) was declared. Results:Experimental results: After flush with EC and 18 h ischemia, a reduction of tissue ATP content (p < 0.01 vs inital value and LPD) was noted. Endothelial damage after ischemia was severe (p < 0.05 vs control), paO₂ was significantly decreased. Clinical results: In the LPD group, duration of ischemia was longer for the grafts transplanted first (SLTx and DLTx: p = 0.0009) as well as second (2. organ DLTx: p = 0.045). Primary transplant function was improved (day 0: SLTx: p = 0.0015; DLTx: p = 0.0095, both vs EC). Duration of ventilation and stay on ICU were shorter (n.s.). Reperfusion injury-associated death was reduced from 8% (EC) to 0 (LPD). Conclusion: In experimental lung preservation, LPD lead to an improved graft function. These results were confirmed in clinical lung transplantation. Clinical lung preservation, therefore, should be carried out by use of LPD.

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High potassium contents in organ preservation solutions cause strong pulmonary vasocontraction

Cited by 69 publications

References 14 publications

Difference in the Effects of Low Temperatures on the Tension of Human Pulmonary Artery and Vein Ring Segments

Difference in the Effects of Low Temperatures on the Tension of Human Pulmonary Artery and Vein Ring Segments

Donor Lung Pretreatment with Prostaglandin E<sub>1</sub> Does Not Improve Lung Graft Preservation

Improvement of Lung Preservation – From Experiment to Clinical Practice

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