LUNG PROCUREMENT BY LOW-POTASSIUM DEXTRAN AND THE EFFECT ON PRESERVATION INJURY

Publisher Website
Google Scholar
Abstract
Background. This clinical study was performed to evaluate the effect of low-potassium dextran (LPD) solution on organ function in human lung transplantation. Methods. A total of 80 patients were included in this study. Donor lungs were flushed with Euro-Collins (EC) solution in 48 cases or LPD (Perfadex) in 32 cases. Subsequently, single- (EC: n=31; LPD: n=15) or double-lung transplantations (EC: n=17; LPD: n=17) were performed. The evaluation parameters of transplant function were the reperfusion injury score (grade I to V); the alveolar/arterial oxygen ratio; the duration of respirator therapy; and the length of intensive care treatment and survival. Results. Incidence and severity of reperfusion injury score were more severe in the EC group (31 of 48: grade I: n=13; II: n=8; III: n=5; IV: n=2; V: n=3; LPD group: 17 of 32 patients; grade I: n=12; II: n=1; III: n=3; IV: n=0 grade V: n=0), leading to death in three patients. In the LPD group, despite of the use of cardiopulmonary bypass, alveolar/arterial oxygen ratio values were significantly (P=0.009) better during the early postoperative phase. Thirty-day mortality was 12% in the EC group and 6% in the LPD group. The one-year survival rate was 79% after the use of LPD (vs. EC: 62%). Conclusions. Graft preservation using LPD leads to better immediate and intermediate graft function after pulmonary transplantation and also results in better long-term survival.