Effect of Prostacyclin on Pulmonary Ischemia-reperfusion Injury according to the State of Lung Inflation

Abstract

Ischemia-reperfusion injury is a serious problem which can occur during lung transplantation. Preservation of pulmonary function by reducing ischemia-reperfusion injury is essential for successful lung transplantation. Although the mechanisms responsible for ischemia-reperfusion lung injury are not clear yet, it is commonly accepted that ischemic time, storage conditions and additive usage of some pharmacologic agents are responsible for the severity of ischemia-reperfusion lung injury. There have been numerous investigations about the effective methods to ameliorate ischemiareperfusion injury. In the present study, we focused on the effectiveness of prostacyclin (PGI2) and lung expansion in reducing pulmonary ischemia-reperfusion injury. The state of inflation of donor lung has been reported to play important role in reducing ischemiareperfusion injury. PGI2, which can be employed with single flush perfusion, has recently been used by many centers and has been proven to provide favorable results. We postulated that the effectiveness of PGI2 would be different according to the application of pulmonary inflation. We evaluated the individual and combined effects of lung expansion and intravenous infusion of PGI2 in warm ischemiareperfusion model. The severity of ischemia-reperfusion injury was assessed by means of pulmonary oxygenation and lung water fraction.