[Improvements in lung preservation: 3 years' experience with a low-potassium dextran solution].

OBJECTIVE

Lung preservation quality is a crucial factor in the success of a lung transplant. In October 2000 we stopped using Euro-Collins (EC) lung preservation solution and began using a low potassium dextran solution (Perfadex [PER]). The objective of the present study was to assess outcome with the 2 solutions.

METHODS

We analyzed the results of 68 lung transplants in which PER was used and compared the results with those of a historical control group consisting of the same number of transplants in which EC was used.

RESULTS

There were no significant differences in the ages and diagnoses of the recipients in the 2 groups. Waiting list time was longer in the PER group. The most frequent cause of donor death in the EC group was craniocerebral trauma (62%), whereas in the PER group it was cerebral hemorrhage (54%). In the PER group more double lung transplants were performed than in the EC group (78% and 53% respectively; P=.002). There were no differences in the use of extracorporal circulation or ischemia time between the 2 groups. Early graft function, based on the patient's oxygenation index (ratio of PaO2 to inspired oxygen fraction [FiO2]) on arrival at the intensive care unit, was similar in the 2 groups. The incidence of severe graft failure (PaO2/FiO2<150 mm Hg) was significantly lower in the PER group than in the EC group (16% and 37% respectively; P=.01). No significant differences in hours of mechanical ventilation or postoperative mortality between the 2 patient series were found.

CONCLUSIONS

Use of the newer lung preservation solution --PER-- led to a 50% lower incidence of severe ischemia-reperfusion graft injury during the early recovery from lung transplantation.