Influence of lung mechanical properties and alveolar architecture on the pathogenesis of ischemia-reperfusion injury.

We tested the hypothesis that lung preservation techniques disarrange lung architecture, increase pulmonary impedance and lead to ischemia-reperfusion injury, which can be prevented by re-establishment of optimal lung geometry. In the first phase, fresh, cold ischemic, preserved lungs insufflated to total lung capacity (TLC) and preserved lungs ventilated with tidal volume prior to reperfusion were submitted to a 60-min ex-vivo reperfusion to evaluate the gas exchange, pulmonary hemodynamic and lung mechanics' properties. In the second phase, we evaluated the mechanical properties of lungs submitted to the same conditions of the first phase.

Alveolar recruitment prevents rapid-reperfusion-induced injury of lung transplants.

Background: Physical factors play an important role in ischemia-reperfusion-induced injury of lung transplants. For example, rapid restoration of reperfusion resulted in severe pulmonary edema and deterioration of pulmonary function of lung explants in an ex vivo reperfusion system. This type of injury can be prevented by a stepwise increase in the perfusion flow rate, or by adding prostaglandin E1 (PGE1) to the blood perfusate during the first 10 minutes.

Prevention of rapid reperfusion-induced lung injury with prostaglandin E1 during the initial period of reperfusion.

We have found that the instantaneous restoration of blood flow causes acute dysfunction and massive edema in rat lungs after 4 hours of room temperature ischemia. This is associated with an early increase in pulmonary artery pressure (Ppa) and can be prevented by a stepwise increase in flow rate during the first 10 minutes of reperfusion. The objectives of this study were to determine whether rapid reperfusion causes lung injury after hypothermic preservation, and whether this injury can be attenuated by a short-course of prostaglandin E1 (PGE1).

Rapid reperfusion causes stress failure in ischemic rat lungs.

Objective: Rapid reperfusion may be injurious to the ischemic lung. Our aim was to confirm that slow reperfusion improves postischemic pulmonary function and to elucidate the ultrastructural changes associated with slow versus rapid reperfusion. METHODS.

Optimal inflation volume for hypothermic preservation of rat lungs.

Background: Recent studies have suggested that preservation of donor lungs with inflation provides better pulmonary function after transplantation, but hyperinflation of pulmonary grafts during storage increases reperfusion pulmonary edema. To elucidate the optimal inflation volume during the preservation period, and the possible role of barotrauma in lung injury after atelectatic storage, we examined the effects of inflation volume and reinflation protocols in hypothermically preserved rat lungs.

Methods: Adult rat lung blocks were preserved at 4 degrees C for 18 hours at various levels of inflation.