The effect of β-2 adrenoreceptor agonist inhalation on lungs donated after cardiac death in a canine lung transplantation model

BACKGROUND: It is a matter of great importance in a donation after cardiac death to attenuate ischemia reperfusion injury (IRI) related to the inevitable warm ischemic time. METHODS: Donor dogs were rendered cardiac-dead and left at room temperature. The dogs were allocated into 2 groups: the beta-2 group (n = 5) received an aerosolized beta-2 adrenoreceptor agonist (procaterol, 350 mu g) and ventilation with 100% oxygen for 60 minutes starting at 240 minutes after cardiac arrest, and the control group (n = 6) received an aerosolized control solvent with the ventilation. Lungs were recovered 300 minutes after cardiac arrest. Recipient dogs underwent left single-lung transplantation to evaluate the functions of the left transplanted lung for 240 minutes after the reperfusion. RESULTS: Oxygenation and dynamic compliance were significantly higher in the beta-2 group than in the control group. The beta-2 group revealed significantly higher levels of cyclic adenosine monophosphate and high-energy phosphates in the donor lung after the inhalation than before it. Histologic findings revealed that the beta-2 group had less edema and fewer inflammatory cells. CONCLUSION: Our results suggest that beta-2 adrenoreceptor agonist inhalation during the pre-procurement period may ameliorate IRI. J Heart Lung Transplant 2012;31:773-9 (C) 2012 International Society for Heart and Lung Transplantation. All rights reserved.