Abstract

Background: The essential damage to the donor organs occurs in the first minutes after reperfusion. In the past, multiple efforts were undertaken to reduce this damage. Using an experimental model, we want to evaluate, if controlled reperfusion with an induction solution (Buckberg) is able to improve the function of the donor lung. Methods: In the slaughter-house unharmed paracardial pig lung lobes (n = 16, middle weight 49 g ± 11) were taken to create for this experimental model. The controlled warm ischemia was 2 hours. After this period all lobes were pressure controlled (PAP < 20 mmHg) perfused with a potassium poor solution (200 ml, 4 °C, perfusion time: 12 minutes ± 2). A storage period followed for 6 hours at 4 °C. By blind randomisation all lungs were distributed to two groups (n = 8 each). In group I (control) each lung was contolled reperfused with pig blood (Hkt 28 %, 37 °C) for 1 hours. In group II the lobes were controlled (PAP < 15 mmHg) reperfused with a Buckberg solution (mixture 1:4 with cold pig blood) for 10 minutes, after this a reperfusion occurred with normothermic blood for 1 hour like in group I. The lungs in both groups were ventilated (V_T 7 ml/khKG, PEEP + 5 cm H20) during warm reperfusion. At the end blood gases, histology, wet-to-dry-ratio and spiral CT scan were evaluated. Results: The lungs of group II were significantly better oxygenated than those from group I (paO2: 598.5 ± 67 mmHg versus 496.7 ± 83 mmHg, ANOVA test: p < 0.05). The wet-to-dry ratio was significantly smaller in group II (5.6 ± 0.6) in comparison to group I (6.6 ± 1.2) (ANOVA test: p < 0.05). The histology showed in group I a higher rate of interstitial edemas. The CT scans of the lungs lobes from group II showed a good morphologic condition. Conclusion: A controlled reperfusion with a cold Buckberg solution seems to reduce not only the lung edema but also improves lung function of the donor organ.