Experimental lung preservation with perfadex: effect of the no-donor nitroglycerin on postischemic outcome Thorsten Wittwer, MD, PhD, Johannes M Albes,

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Experimental lung preservation with perfadex: effect of the no-donor nitroglycerin on postischemic outcome Thorsten Wittwer, MD, PhD, Johannes M Albes, MD, PhD, Antonia Fehrenbach, PhD, Thomas Pech, MS, Ulrich F.W Franke, MD, Joachim Richter, MD, PhD, Thorsten Wahlers, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 125, Issue 6, Pages 1208-1216 (June 2003) DOI: 10.1016/S0022-5223(02)73244-3

Figure 1 Extracorporeal lung circuit. The pulmonary artery is perfused with blood from the lower reservoir (R2) by a small roller pump (P1) at a defined rate of 8 mL/min with deoxygenated xenogenic perfusate. Lungs are ventilated with room air under physiologic time-pressure conditions provided by a small animal respirator. The pulmonary venous blood drains into the main reservoir (S1) and is recirculated by a second roller pump (P2) into the upper reservoir (R1). Constant deoxygenation of perfusate is maintained with specifically gassed standard oxygenators (D). System temperature is controlled by use of water-jacketed vessels and a thermostat. Different filter systems are included (F). The Journal of Thoracic and Cardiovascular Surgery 2003 125, 1208-1216DOI: (10.1016/S0022-5223(02)73244-3)

Figure 2 Flush perfusion time. Preservation groups were composed of LPEC, PER, and PER-NO: PER-NO versus PER, P < .001. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 1208-1216DOI: (10.1016/S0022-5223(02)73244-3)

Figure 3 Oxygenation capacity (Pao2-Pvo2) of rat lungs during the observation period of 50 minutes. Preservation groups were composed of LPEC, PER, and PER-NO: PER-NO versus PER, P = .001; PER-NO versus LPEC, P < .001. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 1208-1216DOI: (10.1016/S0022-5223(02)73244-3)

Figure 4 PVR of rat lungs during the observation period of 50 minutes. Preservation groups were composed of LPEC, PER, and PER-NO: PER-NO versus PER, P < .001; PER-NO versus LPEC, P = .001. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 1208-1216DOI: (10.1016/S0022-5223(02)73244-3)

Figure 5 PIP of rat lungs during the observation period of 50 minutes. Preservation groups were composed of LPEC, PER, and PER-NO: PER-NO versus PER, P = .018. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 1208-1216DOI: (10.1016/S0022-5223(02)73244-3)

Figure 6 W/D weight ratio of rat lungs after the observation period of 50 minutes. Preservation groups were composed of LPEC, PER, and PER-NO. Differences were statistically not significant. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 1208-1216DOI: (10.1016/S0022-5223(02)73244-3)

Figure 7 Volume fraction of intra-alveolar edema in rat lungs after the observation period of 50 minutes. Preservation groups were composed of LPEC, PER, and PER-NO. Differences were statistically not significant. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 1208-1216DOI: (10.1016/S0022-5223(02)73244-3)

Figure 8 Sections of lung parenchyma after preservation with PER (A; normal histologic structure without edema) and modified EC (B; formation of intra-alveolar edema). AL, Alveolus; EN, endothelial cell; EP, epithelial cell; CA, capillary; ED, edema. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 1208-1216DOI: (10.1016/S0022-5223(02)73244-3)

Figure 9 Ratio of stereologically determined volume fractions of vessel lumen to vessel wall. Preservation groups were composed of LPEC, PER, and PER-NO. Differences were statistically not significant. Control, Untreated normal control lungs. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 1208-1216DOI: (10.1016/S0022-5223(02)73244-3)