Wada H, Fukuse T, Nakamura T, Liu C J, Bando T, Kosaka S, Ariyasu T, Hitomi S
Department of Thoracic Surgery, Chest Disease Research Institute, Kyoto university, Japan.
Ann Thorac Surg. 1996 Mar;61(3):963-8. doi: 10.1016/0003-4975(95)01118-8.
ET-Kyoto (ET-K) solution, proven safe for 20-hour lung preservation, was modified to achieve longer preservation: ET-K2 solution with more buffer capacity and ET-K3 with less potassium.
Lungs were preserved with one of the three solutions (with prostaglandin E1 at 4 degrees C for 48 hours (n = 5 for each). Left lung transplantation was performed and evaluated for 6 hours.
Each solution became acidic after preservation (p < 0.01), though the change was lowest in the ET-K2 solution. All animals in the ET-K and ET-K3 groups survived for 6 hours after reperfusion, but only 1 survived in the ET-K2 group (p < 0.05). In all groups, partial pressure of oxygen in arterial blood decreased gradually after reperfusion. Pulmonary vascular resistance after reperfusion was significantly lower in the ET-K group than in the ET-K3 group (p < 0.01). Scanning electron microscopic examination showed that endothelial cell swelling and disruption were milder in the ET-K group (with the solution containing potassium of 44 mEq/L) than in the ET-K3 group.
Lung preservation can be achieved for 48 hours in ET-K and ET-K3 solutions. Enhancement of buffer capacity provides no advantage. Potassium at 44 mEq/L does not cause deterioration of endothelial cells.
已证实ET-京都（ET-K）溶液用于肺保存20小时是安全的，对其进行改良以实现更长时间的保存：具有更大缓冲能力的ET-K2溶液和钾含量更低的ET-K3溶液。
用三种溶液之一（添加前列腺素E1）在4℃下保存肺48小时（每组n = 5）。进行左肺移植并评估6小时。
保存后每种溶液均变酸（p < 0.01），尽管ET-K2溶液中的变化最小。ET-K组和ET-K3组的所有动物在再灌注后存活6小时，但ET-K2组仅1只存活（p < 0.05）。在所有组中，再灌注后动脉血中的氧分压逐渐降低。再灌注后ET-K组的肺血管阻力显著低于ET-K3组（p < 0.01）。扫描电子显微镜检查显示，ET-K组（溶液钾含量为44 mEq/L）的内皮细胞肿胀和破坏比ET-K3组更轻。
ET-K溶液和ET-K3溶液可实现肺48小时的保存。增强缓冲能力并无优势。44 mEq/L的钾不会导致内皮细胞恶化。
