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J Thorac Cardiovasc Surg 1994;108:92-98
© 1994 Mosby, Inc.

CARDIAC AND PULMONARY REPLACEMENT

Effects of newly developed solutions containing trehalose on twenty-hour canine lung preservation

Kyoto, Japan

From the Department of Thoracic Surgery, Chest Disease Research Institute, Kyoto University, Kyoto, Japan.

Received for publication Oct. 25, 1993. Accepted for publication Jan. 28, 1994. Address for reprints: Hiromi Wada, MD, Department of Thoracic Surgery, Chest Disease Research Institute, Kyoto University, Shogoin Sakyo-ku, Kyoto 606, Japan.

Abstract

Trehalose is a nonreducing disaccharide that stabilizes the cell membrane under various stressful conditions. A previous study demonstrated that trehalose was effective in 12-hour canine lung preservation. We have developed new preservation solutions containing trehalose: an extracellular type ET-Kyoto solution (Na 100 mmol/L, K 44 mmol/L) and an intracellular type IT-Kyoto solution (Na 20 mmol/L, K 130 mmol/L). The composition of these solutions is identical except for the electrolyte content. We examined their efficacy in 20-hour lung preservation. Canine lungs were flushed with ET-Kyoto (group A, n = 6), with IT-Kyoto and prostaglandin E₁ (25µg/kg) (group B, n = 6), or with Euro-Collins solution and prostaglandin E₁ (25µg/kg) (group C, n = 7), and stored for 20 hours at 4° C. Left lung transplantation was performed and evaluated for up to 130 minutes. The flush time was similar in the three groups. Arterial oxygen tensions (inspired oxygen fraction = 0.5) in group A were uniformly excellent (303.3 ± 7.0 mm Hg 70 minutes after reperfusion and 303.0 ± 19.6 mm Hg 130 minutes after reperfusion) and significantly higher than in group B (202.6 ± 32.0 mm Hg, p < 0.05, and 197.8 ± 44.0 mm Hg, p = 0.054, respectively) or group C (185.9 ± 23.0 mm Hg, p < 0.01, and 155.7 ± 36.3 mm Hg, p < 0.05, respectively). Peak inspiratory pressure in group A was significantly lower than in groups B and C (p < 0.05). Wet/dry weight ratio in group A was significantly lower than in groups B (p < 0.05) and C (p < 0.01). Histologic and scanning electron microscopic examinations showed better preservation in group A than in groups B and C. We conclude that ET-Kyoto is superior to IT-Kyoto and to Euro-Collins solution for 20-hour lung preservation. (J THORACCARDIOVASCSURG1994;108:92-8)

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