The Annals of Thoracic Surgery, Vol 51, 557-561, Copyright © 1991 by The Society of Thoracic Surgeons
Improved lung preservation with cold air storage
ND Kon, MH Hines, CD Harr, LR Miller, CL Taylor, AR Cordell and SA Mills
Department of Cardiothoracic Surgery, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina.
Conventional topical slush cooling limits lung transport to 4 to 6 hours.
For this canine study of an alternate air cooling system, 37 canine lungs
were removed: 24 were placed in plastic bags, and inserted in a
Transplanthermm container at core air temperatures (n = 6 lungs each) of
(A) 4 degrees C, (B) 8 degrees C, (C) 12 degrees C, and (D) 20 degrees C; 6
were stored conventionally in ice slush (E); and 7 were transplanted
immediately (F). After 8 hours, the stored lungs were transplanted and the
contralateral pulmonary artery was ligated. Survival, arterial oxygen
tension, and extravascular lung water were monitored at 15 minutes and
every hour for 4 hours. Four-hour survival was 100% in groups A, B, and F;
83% in group C, 50% in group D, and 17% in group E. The mean arterial
oxygen tension at 1 hour was lower in group E (6.4 +/- 2.4 kPa) than in
group A (39.8 +/- 13.2 kPa) (p = 0.0002) or in group F (42.0 +/- 16.2 kPa)
(p = 0.0035). Extravascular lung water in group E was higher at 15 minutes
(15.44 +/- 5.63 mL/kg) than in group A (3.76 +/- 0.63 mL/kg) (p = 0.0001)
and group F (4.69 +/- 1.65 mL/kg) (p = 0.003). Cold air storage appears to
provide better lung preservation than hypothermic immersion in ice slush.
