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Lookup NU author(s): Emeritus Professor Paul FlecknellORCiD, Professor John Dark
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Objective: Previous studies have suggested the amelioration of lung reperfusion injury when initial reperfusion is undertaken with leukocyte-depleted blood. Pharmacologic agents, such as pentoxifylline, are also effective, but no previous studies have demonstrated which is superior. We investigated these agents in a porcine model of left single-lung transplantation. Methods: Donor lungs were preserved with modified Euro-Collins solution for a mean ischemic time of 18.6 hours. Gas exchange, pulmonary vascular resistance, neutrophil elastase level, and free radical release (measured on the basis of malonaldehyde levels) were assessed over a 12-hour period. Group A (n = 5) was a control group with no interventions added. Group B was reperfused through an extracorporeal circuit incorporating a leukocyte-depleting filter for 30 minutes before conventional blood flow was restored. Group C was reperfused with the addition of intravenous pentoxifylline (2 mg · kg-1 · h-1). Results: Groups B and C were similar in terms of oxygenation, pulmonary vascular resistance, and free radical release. Group B displayed increased levels of neutrophil elastase. Both groups were superior with regard to these outcome measures compared with control group A. Conclusions: Pentoxifylline, when administered to recipient animals, attenuates reperfusion injury to a degree similar to that seen with leukocyte-depleted reperfusion. This technique is simple, safe, and as effective as using a more complex extracorporeal circuit incorporating a leukocyte-depleting filter to ameliorate acute lung injury.
Author(s): Clark SC, Rao JN, Flecknell PA, Dark JH
Publication type: Article
Publication status: Published
Journal: Journal of Thoracic and Cardiovascular Surgery
Year: 2003
Volume: 126
Issue: 6
Pages: 2052-2057
Print publication date: 01/12/2003
ISSN (print): 0022-5223
ISSN (electronic): 1097-685X
Publisher: Mosby, Inc.
URL: http://dx.doi.org/10.1016/S0022-5223(03)01187-5
DOI: 10.1016/S0022-5223(03)01187-5
PubMed id: 14688725
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