Surfactant function in lung transplantation after 24 hours of ischemia: Advantage of retrograde flush perfusion for preservation Martin Strüber, MDa,

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Surfactant function in lung transplantation after 24 hours of ischemia: Advantage of retrograde flush perfusion for preservation Martin Strüber, MDa, Jens M. Hohlfeld, MDb, Theo Kofidis, MDa, Gregor Warnecke, MDa, Jost Niedermeyer, MDb, Sebastian P. Sommer, MSa, Axel Haverich, MDa The Journal of Thoracic and Cardiovascular Surgery Volume 123, Issue 1, Pages 98-103 (January 2002) DOI: 10.1067/mtc.2002.119063 Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 1 PO2/FIO2 of miniature pigs before single lung transplantation (basal) and after 0.5 to 7 hours of reperfusion after single lung transplantation and clamping of the contralateral lung. Grafts were preserved with LPD solution by antegrade versus retrograde flush perfusion and stored for 24 hours. The Journal of Thoracic and Cardiovascular Surgery 2002 123, 98-103DOI: (10.1067/mtc.2002.119063) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 2 Dynamic lung compliance 0.5 to 7 hours after single left lung transplantation and clamping of the contralateral lung. Grafts were preserved with LPD solution by antegrade versus retrograde flush perfusion and stored for 24 hours. The Journal of Thoracic and Cardiovascular Surgery 2002 123, 98-103DOI: (10.1067/mtc.2002.119063) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 3 Extravascular lung water index 0.5 to 7 hours after single left lung transplantation and clamping of the contralateral lung. Grafts were preserved with LPD solution by antegrade versus retrograde flush perfusion and stored for 24 hours. The Journal of Thoracic and Cardiovascular Surgery 2002 123, 98-103DOI: (10.1067/mtc.2002.119063) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 4 Minimal surface tension of the BAL fluid in milli-Newtons per meter, as determined with a bubble surfactometer. Results are shown before flush perfusion of the right lung (basal) and after 2 hours of reperfusion of the transplanted left lung. The Journal of Thoracic and Cardiovascular Surgery 2002 123, 98-103DOI: (10.1067/mtc.2002.119063) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 5 SA/LA ratio of BAL fluid. Results are shown before flush perfusion of the right lung (basal) and after 2 hours of reperfusion of the transplanted left lung. A significant increase P =.037) was found after reperfusion (2 hours) in the antegrade group. The Journal of Thoracic and Cardiovascular Surgery 2002 123, 98-103DOI: (10.1067/mtc.2002.119063) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions