Aprotinin improves pulmonary function during reperfusion in an isolated lung model

Background. We hypothesized that the use of aprotinin would ameliorate the reperfusion injury observed after lung transplantation because of a reduction in the inflammatory response. Methods. We used an isolated, whole blood-perfused, ventilated rabbit lung model to study the effects of aprotinin during reperfusion. The control animals (group A, n = 8) underwent lung harvest after pulmonary arterial prostaglandin E₁ injection and Euro-Collins preservation flush before saline storage for 18 hours at 4°C. The experimental groups received either a low dose (3,000 KIU/mL; group B, n = 8) or a high dose (10,000 KIU/mL; group C, n = 8) of aprotinin added to the pulmonary flush before storage. Each lung was reperfused at 37°C at a rate of 60 mL/min. Results. The arterial partial pressure of oxygen values of group 15 (low-dose aprotinin) were significantly higher than those of group A (control) after 10 minutes of reperfusion (69.19 ± 5.69 mm Hg versus 264.30 ± 48.59 mm Hg, respectively, p = 0.001). Similar results were recorded at 20 and at 30 minutes of reperfusion. Similarly, after 10 minutes of reperfusion, the differences between groups A and C were 69.19 ± 5.69 mm Hg versus 235.91 ± 28.63 mm Hg, respectively (p = 0.001). Conclusions. The addition of aprotinin to the Euro-Collins pulmonary flush significantly improves arterial oxygenation in the early reperfusion period. The enhanced oxygenation suggests that aprotinin may offer protection against early reperfusion injury. (C) 2000 by The Society of Thoracic Surgeons.