Lung preservation: A review of current practice and future directions

Preservation of intraalveolar surfactant in a rat lung ischaemia/reperfusion injury model

“…Furthermore, lungs preserved with either ECS 115 or ECS 10 exhibited a significantly higher peak inspiratory pressure compared to lungs preserved with ECS 40. Since the tidal volume and the positive end-expiratory pressure were constant in the experimental settings, this increase in PIP indicates a decrease in lung compliance [19]. The wet/dry ratio data did not show significant differences between the three groups.…”

“…However, current preservation methods are only satisfactory for ischaemic periods of up to 6 h [18,19]. Extension of tolerable ischaemic periods due to improved lung preservation would have the advantage of being able to perform lung transplantation as a nonemergency procedure, thereby allowing better matching of donor and recipient [18,19]. The enormous variation in clinical practice together with the fact that the incidence of primary graft failure has changed very little during the 1990s, make it likely that current lung preservation techniques are still suboptimal [23].…”

“…While there is general agreement as to how pulmonary functional integrity should be evaluated [19], standard criteria for the assessment of the structural integrity of the preserved lung have not yet been defined. The present study has shown that the preservation of intraalveolar surfactant ultrastructure correlates with post-ischaemic lung function.…”

“…I/R injury, which is characterized by pulmonary oedema formation associated with an increase in pulmonary artery pressure and hypoxaemia [17], is the major reason for early graft dysfunction in clinical lung transplantation [18]. The clinically relevant prevalence of early graft dysfunction has been estimated to be 15±35%, with a severity ranging from very mild acute lung injury to ARDS [18], and it is clearly stated that the quality of lung preservation is a key determinant of initial graft dysfunction [18,19].…”

Efeito da ventilação com diferentes frações inspiradas de oxigênio e do alopurinol na isquemia-reperfusão pulmonar em ratos

“…O transplante de pulmão tornou-se uma opção terapêutica em pacientes portadores de estágios finais de doenças pulmonares em vários centros especializados [1][2][3] . Embora tenha alcançado bons resultados, continua havendo fatores limitantes para a sua realização, entre eles a dificuldade de obtenção do enxerto e a rejeição, a infecção e a preservação do órgão.…”