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The Annals of Thoracic Surgery, Vol 55, 1453-1459, Copyright © 1993 by The Society of Thoracic Surgeons
TM Egan, KS Ulicny Jr, CJ Lambert Jr and BR Wilcox
The pulmonary donor pool would increase substantially if lungs could be
safely transplanted after cessation of circulation. To determine whether
the addition of the free radical scavenger dimethylthiourea to the
perfusate of cadaver lungs could improve graft function, canine donors were
sacrificed, and lungs retrieved 2 hours after death. In a blinded fashion,
dimethylthiourea was added to the modified Euro- Collins solution and
infused into recipients (n = 9) perioperatively; a placebo was included in
the perfusate of control animals (n = 9). Donor animals were ventilated
with 100% oxygen only during flush and harvest. Recipients were rendered
dependent upon the single left transplanted lung by occlusion of the right
pulmonary artery and bronchus 1 hour after transplantation. Ventilation was
maintained at a constant inspiratory oxygen fraction of 0.4. Recipients
were followed up for 8 hours or until death. Three of 9 control animals
survived the 8-hour observation period, whereas 6 of 9 recipients of
cadaver lungs harvested with dimethylthiourea survived the observation
period. Two deaths in the dimethylthiourea group occurred after 7 hours,
implying that the effects of the ischemia and reperfusion injury were
ameliorated by the use of this agent in this model. This study supports the
notion that perfusate modification may improve the yield of cadaver lung
retrieval and may allow for transplantation of lungs harvested from
cadavers after cessation of circulation.
ARTICLES
Effect of a free radical scavenger on cadaver lung transplantation
Department of Surgery, University of North Carolina School of Medicine, Chapel Hill.
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