Ultrastructural damage to the preserved lung and its function after reperfusion.

Objective: This study was undertaken to clarify what damage to a lung during cold storage influenced the function of transplanted lung after reperfusion.
Methods: We examined the ultrastructural damage in preserved right lung before reperfusion, and the function of transplanted left lung, in a same dog and measured the pulmonary artery oxygen pressure after reperfusion and the wet-to-dry-weight ratio. We compared these findings between those dogs that survived until six hours after reperfusion (Alive Group) and those dogs that did not survive (Dead Group). We also investigated any correlation between the ultrastructural damage in the preserved lung and the function of the transplanted lung.
Results: The frequency of protrusion and destruction of the endothelial cells in the small pulmonary artery, and vacuolization of pneumocytes, in the Dead Group was significantly higher than that in the Alive Group. A correlation was found between the frequency of two kinds of ultrastructural damage; vacuolization in the endothelial cells in the small pulmonary artery and vacuolization in the pneumocytes, and the pulmonary artery oxygen pressure at 1-hour after reperfusion. A correlation was also found between the frequency of the vacuolization of pneumocytes and the wet-to-dry-weight ratio.
Conclusions: Findings suggested that a lung suffering severe damage to intracellular structure during hypothermic preservation is unable to function sufficiently after reperfusion and is at high risk for early graft failure.