Surfactant abnormalities after single lung transplantation in dogs: impact of bronchoscopic surfactant administration.

Objective: Disturbances of the alveolar surfactant system have been implicated in the pathogenesis of reperfusion injury. The aim of this study was to evaluate the influence of exogenous surfactant administration on surfactant properties in a model of single lung transplantation.

Methods: We performed heterologous, left lung transplantation (+4 degrees C ischemia; 24 hours, Euro-Collins solution) in 6 foxhounds (untreated) and in 6 animals that received calf lung surfactant extract (Alveofact) prior to explantation (only donor lung; 50 mg/kg body weight) and immediately after onset of reperfusion (both lungs, 200 mg/kg body weight).

Bronchoscopic surfactant administration preserves gas exchange and pulmonary compliance after single lung transplantation in dogs.

Background: Surfactant abnormalities have been implicated in reperfusion injury and respiratory failure in lung transplantation.

Methods: We investigated the efficacy of bronchoscopic administration of a bovine natural lung surfactant extract (Alveofact) to improve gas exchange and lung mechanics after heterologous left lung transplantation in foxhounds (+4 degrees C ischemia for 24 hours, conservation with Euro-Collins solution). Animals received either no surfactant therapy (untreated controls, n = 6) or 50 mg/kg body weight (prior to explantation, only graft) and 200 mg/kg body weight Alveofact (immediately after reperfusion, both lungs, n = 6).

Pulmonary blood flow is inhomogeneously reduced after Euro Collins-preservation and lung transplantation.

Background: Vasoconstriction after lung transplantation is a well-known phenomenon, but only limited information is available on blood flow distribution after ischemia and reperfusion. The aim of our study was to determine the regional flow characteristics in transplanted and native dog lungs after 24 hours of cold storage and preservation with Euro Collins-solution.

Methods: Six pairs of weight-matched Foxhounds (25 to 30 kg) were used.

Mediastinitis after cardiac surgery--epidemiology and current treatment.

Mediastinal infection is a feared complication observed after 0.4%-5% of cardiac operations. Even today the mortality remains as high as 20%-40%.