Effects of warm ischemia, flushing, and 24-hour cold preservation on rabbit lungs from non-heart-beating donors

The shortage of donor lungs limits the number of patients who can benefit from lung transplantation. We studied effects of flushing, warm ischemia after cessation of circulation, and cold preservation in rabbit lungs from cadaver donors (CDs) to investigate the clinical application of cadaver lung transplantation. We measured filtration coefficient (Kf) as micro-vascular permeability of the graft lungs as a sensitive indicator of lung injury in five study groups. Group A : no warm ischemia, no graft flushing, and no cold preservation (Kf=0.34±0.14), Group B : no warm ischemia, with graft flushing, and no cold preservation (Kf=0.42±0.06), Group C : no warm ischemia, with graft flushing, and cold preservation (Kf=0.60±0.13), Group D : warm ischemia for 60 minutes, with graft flushing, and cold preservation (Kf=0.92±0.21); Group E : warm ischemia for 90 minutes, with graft flushing, and cold preservation (Kf =1.25±0.09). Prolonged cold preservation significantly increased Kf of the graft, and aggravated the microvascular injury caused by warm ischemia after cessation of circulation.