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The Annals of Thoracic Surgery, Vol 58, 50-56, Copyright © 1994 by The Society of Thoracic Surgeons
K Okabayashi, M Aoe, SR DeMeester, JD Cooper and GA Patterson
Early graft dysfunction remains a significant problem in clinical lung
transplantation. Pentoxifylline, a methylxanthine derivative, has been
shown to have various beneficial effects on neutrophil-induced lung injury.
We investigated effects of pentoxifylline on early posttransplantation lung
function in a canine allograft model. Ten dogs underwent left lung
allotransplantation. Donor lungs were flushed with modified Euro-Collins
solution (50 mL/kg) and stored in an inflated state for 18 hours at 1
degrees C. In five experiments (group I), pentoxifylline was added to the
flush and storage solutions (200 mg/L) at the time of harvest. The
recipient animals received pentoxifylline (20 mg/kg intravenously) before
reperfusion followed by pentoxifylline (0.1 mg.kg-1.min-1 intravenously)
during the 6-hour posttransplantation assessment period. In group II,
donors and recipients received no pentoxifylline. To evaluate only
allograft function, the right main pulmonary artery and bronchus were
ligated immediately after implantation. For 6 hours thereafter hemodynamics
and gas exchange were assessed at 15-minute intervals while the animal was
ventilated at an inspired oxygen fraction of 1.0. After 1 hour of
assessment there was a significant difference in gas exchange between the
groups, which persisted until the end of the study. By the end of the
6-hour assessment, the mean arterial oxygen tension was 236.7 mm Hg for
group I versus 101.1 mm Hg for group II (p < 0.01), and the
alveolar-arterial oxygen difference was 443.1 mm Hg versus 562.2 mm Hg (p
< 0.015). Hemodynamics were not different between groups.(ABSTRACT
TRUNCATED AT 250 WORDS)
ARTICLES
Pentoxifylline reduces lung allograft reperfusion injury
Department of Surgery, Washington University School of Medicine, Barnes Hospital, St. Louis, Missouri 63110.
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