Pulmonary Preservation Effect of Nitroglycerine in Isolated Rat Lung Reperfusion Model S. Jheon, Y.M. Lee, S.W. Sung, J.H. Choh, K.Y. Kwon, D.Y. Keum, and C.K. Park ABSTRACT Purpose. Though nitric oxide has many favorable protective effects on donor lungs, it may also have cytotoxic side effects. In this regard, we investigated whether administration of nitroglycerine, a nitric oxide donor, could minimize ischemia-reperfusion injury in an isolated rat lung reperfusion model. Materials and methods. Thirty-five Sprague-Dawley rats were used for this experiment. The nitroglycerine (NTG) group (n  18) received the drug intravenously and the 17 control group hosts were treated with the same amount of normal saline. The heart-lung block was retrieved, weighed, and maintained in University of Wisconsin solution for 24 hours at 10°C. Reperfusion was performed using human blood diluted in Krebs-Hensleit solution for 60 minutes. Peak inspiratory pressure, pulmonary artery pressure, and blood gas analysis were performed. After 60 minutes of reperfusion, the amount of protein in bronchoalveolar lavage (BAL) fluid and the myeloperoxidase (MPO) activity in the lung were measured. Results. There were no major statistical differences between the two groups in peak inspiratory pressure and pulmonary artery pressure, but the NTG group maintained lower pulmonary artery pressure during the whole period of reperfusion. Oxygen tension in the NTG group was significantly higher, whereas there were no differences in carbon dioxide tension, BAL fluid, protein, or MPO activity. Conclusion. Administration of NTG before donor lung preservation resulted in better lung protection, a possible strategy for clinical application. P ROTECTION AGAINST ischemia-reperfusion injury is crucial for successful transplantation of the lung. It has been known that nitric oxide has many favorable effects on donor lungs, but at the same time, it has some potential cytotoxic side effects. In this regard, we investigated whether administration of nitroglycerin (NTG), a nitric oxide (NO) donor, could decrease ischemia-reperfusion injury in an isolated rat lung reperfusion model. MATERIALS AND METHODS Thirty-five male Sprague-Dawley rats were managed according to the guidelines for laboratory animals. After intraperitoneal injec- tion of ketamine and xylaxine, tracheostomy was performed and mechanical ventilation (Harvard rodent ventilator, model 683, UK) maintained with a 3-mL tidal volume and a respiratory rate of 60 per minute. After heparinization by femoral vein cannulation, 0.05 mg of NTG was infused for 10 minutes in the NTG group (n  18) and same amount of saline in the control group (n  17). After a midline sternal split, a pulmonary artery cannula was placed through the right ventricular outflow tract. For the NTG group, we used 20 mL of 4°C University of Wisconsin (UW) solution with 0.1 mg/mL of NTG as a flushing solution by 20 cm H 2 O pressure; for the control group, we omitted NTG. After completion of flushing, the trachea was ligated on end-inspiration, and the heart-lung block retrieving, weighed, and stored in UW solution at 10°C for 24 hours. After 24 hours preservation, pulmonary artery and airway cannulae were placed and fixed. The heart-lung block was placed in a glass chamber with adequate temperature and humidity. Mechan- From the Departments of Thoracic Surgery (S.J.) and Physi- ology (Y.M.L.) Catholic University of Daegu; Department of Thoracic Surgery (S.W.S., J.H.C.), Seoul National University; and Department of Pathology (K.Y.K.) and Thoracic Surgery (D.Y.K., C.K.P.), Keimyung University, Daegu, Korea. Address reprint requests to Chang Kwon Park, MD, Tho- racic Surgery, Keimyung University Dongsan Medical Centre, 194, Dongsan-dong, Chung-gu, Daegu, 700-712, Korea.E-mail: ckpark80@dsmc.or.kr © 2004 by Elsevier Inc. All rights reserved. 0041-1345/04/$–see front matter 360 Park Avenue South, New York, NY 10010-1710 doi:10.1016/j.transproceed.2004.06.045 Transplantation Proceedings, 36, 1933–1935 (2004) 1933