Abstract
Nitric oxide (NO) is believed to be identical to endothelium-dependent-relaxing-factor, a potent vasodilator. In addition, NO has been founded to play a critical role in the maintenance of vascular permeability through its attenuation of polymorphonuclear neutrophils (PMN) and platelets. In the present study, we have evaluated the effects of inhaled NO at reperfusion in canine left single-lung allotransplantation from a non-heart-beating donor. Twelve weight-matched pairs of adult mongrel dogs were used. The donor dogs were sacrificed by an intravenous injection of potassium chloride without heparinization. They were left at room temperature for 3 hours. Then, the recipient dogs received a left single-lung allotransplantation. After implantation, the right bronchus and pulmonary artery were ligated. In Group 1 (n=6), NO gas was administered continuously at a concentration of 40 parts per million throughout a 6-hour assessment period. In Group 2 (n=6), nitrogen gas was administered in the same manner as NO, for control. The survival time in Group 1 was significantly longer than that in Group 2. The arterial oxygen tension in Group 1 was significantly higher than that in Group 2. The pulmonary vascular resistance was significantly lower in Group 1 than in Group 2. The aortic pressure and the cardiac output each did not differ significantly between the two groups. Myeloperoxidase activity was significantly lower in Group 1 than in Group 2. Inhaled NO at reperfusion is beneficial in lung transplantation from non-heart-beating donors because it attenuates ischemia-reperfusion injury by inhibiting PMN activation and vasodilating pulmonary vasculature.
Similar content being viewed by others
References
Cooper JD, Pearson FG, Patterson GA, Todd TRJ, Ginsberg RJ, Goldberg M, et al. Technique of successful lung transplantation in humans. J Thorac Cardiovasc Surg 1987; 93: 173–81.
Homatas J, Bryant L, Eiseman B. Time limits of cadaver lung viability. J Thorac Cardiovasc Surg 1968; 56: 132–40.
Yamazaki F, Wada H, Aoki M, Inui K, Hitomi S. An evaluation of the tolerance of the autotransplanted canine lung against warm ischemia. Jpn J Surg 1989; 19: 326–33.
Egan TM, Lambert CJ, Reddick R, Ulicny KS, Keagy BA, Wilcox BR. A strategy to increase the donor pool. Ann Thorac Surg 1991; 52: 1113–21.
Kayano K, Date H, Uno K, Shimizu N, Teramoto S. Evaluation of the viability of the canine cadaver lung for transplantation. Acta Med Okayama 1993; 47: 329–37.
Umemori Y, Date H, Uno K, Aoe M, Ando A, Shimizu N. Improved lung function by urokinase infusion in canine lung transplantation using non-heart-beating donors. Ann Thorac Surg 1995; 59: 1513–8.
Cooke JP, Tsao PS. Cytoprotective effect of nitric oxide. Circulation 1993; 88: 2451–4.
Palmer RMJ, Ferrige AG, Moncada S. Nitric oxide release accounts for the biological activity of endothelium-relaxing factor. Nature 1987; 327; 524–6.
Moncada S, Palmer RMJ, Higgs EA. Nitric oxide: physiology, pathophysiology, and pharmacology. Pharmacol Rev 1991; 43: 109–42.
Kubes P, Suzuki M, Granger DN. Nitric oxide: an endogenous modulator of leukocyte adhesion. Proc Natl Acad Sci USA 1991; 88: 4651–5.
Kubes P, Granger DN. Nitric oxide modulates microvascular permeability. Am J Physiol 1992; 262: 611–5.
Okabayashi K, Triantafillou AN, Yamashita M, Aoe M, DeMeester SR, Cooper JD, et al. Effects of inhaled nitric oxide on lung allograft in early postoperative period. J Thorac Cardiovasc Surg (in press).
Kraiwsz JE, Sharon P, Stenson WF. Quantitative assay for acute intestinal inflammation based on myeloperoxidase activity: assessment of inflammation in rat and hamster models. Gastroenterology 1984; 87: 1344–50.
Smith PK, Krohn RI, Hermanson GT, Mallia AK, Gartner FH, Provenzano MD, et al. Measurement of protein using bicinchoninic acid. Anal Biochem 1985; 150: 76–85.
Date H, Matsumura A, Manchester JK, Cooper JM, Lowry OH, Cooper JD. Changes in alveolar oxygen and carbon dioxide concentration and oxygen consumption during lung preservation. J Thorac Cardiovasc Surg 1993; 105: 492–501.
Roberts CS, Hennington MH, D’Armini, Griffith PK, Lemasters JJ, Egan TM. Donor lungs from ventilated cadavers. Impart of a free radical scavenger. J Heart Lung Transplant 1996; 15: 275–82.
Gryglewski RJ, Palmer RMJ, Moncada S. Superoxide anion is involved in the breakdown of endothelium-derived vascular relaxing factor. Nature 1986; 3228: 454–6.
Date H, Triantafillou AN, Trulock EP, Pohl MS, Cooper JD, Patterson GA. Inhaled nitric oxide reduces human lung allograft dysfunction. J Thorac Cardiovasc Surg 1996; 111: 913–9.
Murakami S, Bacha EA, Harve P, Detruit H, Chapelier AR, Dartevelle PG, et al. Prevention of reperfusion injury by inhaled nitric oxide in lungs harvested from non-heart-beating donors. Ann Thorac Surg 1996; 62: 1632–8.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Takashima, S., Date, H., Aoe, M. et al. Effects of inhaled nitric oxide in canine lung transplantation from non-heart-beating donor. Jpn J Thorac Caridovasc Surg 46, 657–663 (1998). https://doi.org/10.1007/BF03217798
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03217798