Raffinose-low potassium dextran solution in clinical lung transplantation: a retrospective study / 中华器官移植杂志

ABSTRACT

ObjectiveTo evaluate the security and effectiveness of raffinose-low potassium dextran solution (RLPDs) for donor lung preservation.MethodsFrom Sep.2002 to Dec.2011,131patients underwent lung transplantation in our institution,including 81cases of single lung transplantation and 50 cases of bilateral lung transplantation.There were 95 males and 36 females.A total of 129 donors were used for organ harvest.Two donors denoted their lungs to four patients receiving single lung transplantation. All the donors were flushed, perfused antegradely and retrogradely,and preserved with hypothermal RLPDs.The repeated reperfusion was necessary when the cold ischemic time was fairly long and the function of donor was poor.During operation,the blood gas analysis,mean pulmonary artery pressure (mPAP) and breathing mechanics were monitored.Postoperatively,all the recipients received re-examination of cardiac ultrasonography,pulmonary function,blood gas analysis and chest imaging.ResultsAll lung transplantations were performed successfully,with a mean cold ischemic time of (193±21) min (range,65-630 min).There was a significant relationship between postoperative pneumonedema and donor lung cold ischernic time (P＜0.05),which was also observed between postoperative pneumonedema and primary graft dysfunction (P＜0.01). The blood gas analysis and oxygenation index were significantly improved postoperatively,with the mPAP and parameters of breathing mechanics being descended to a normal level.There were 24 early deaths in the first month post-transplant,with a mortality of 18.3％ (24/131),including 11cases of sepsis,7 cases of primary graft dysfunction,3 cases of heart failure,1case of bronchial stomal leak,1case of acute rejection,and 1case of pulmonary infarction.The pulmonary function was improved significantly 3 months postoperatively.Conclusion RLPDs is efficient in the preservation of donor lung,with the ability to alleviate ischemic reperfusion injury and improve pulmonary function.