Am. J. Respir. Crit. Care Med., Volume 156, Number 2, August 1997, 567-572

Effects of Early Surfactant Treatment Persisting for One Week after Lung Transplantation in Rats

MICHIEL E. ERASMUS, GERT J. H. HOFSTEDE, ARJEN H. PETERSEN, HENK P. HAAGSMAN, SIDARTO BAMBANG OETOMO, and JOCHUM PROP

Department of Cardiopulmonary Surgery, Research Division and the Department of Pediatrics, University Hospital Groningen, Groningen; and the Laboratory of Veterinary Biochemistry, Utrecht University, Utrecht, The Netherlands

We investigated whether pulmonary surfactant in rat lung transplants recovered during the first week post-transplantation, along with symptoms of the reimplantation response, and whether this recovery was affected by early surfactant treatment. The severity of pulmonary injury was varied by transplanting left lungs with 6-h and 20-h ischemia (n = 12 and 19, respectively). Half of the transplants were treated by instillation of surfactant before reperfusion. Lungs from sham operated, and normal rats (n = 4 and 5, respectively) served as controls. The pulmonary injury severely impaired lung transplant function; 10 of the worst affected animals died. After 1 wk, symptoms of reimplantation response and properties of pulmonary surfactant were assessed. If untreated, the reimplantation response had almost resolved in the 6-h but not in the 20-h ischemia group; pulmonary surfactant, however, continued to be deficient in both ischemia groups (low amounts of surfactant phospholipids and surfactant protein A [SP-A]). Surfactant treatment improved the recovery from injury in the 20-h ischemia group resulting in normal lung function and amounts of surfactant phospholipids. Amounts of SP-A were not improved by surfactant treatment. In conclusion, early surfactant treatment enhances recovery from transplantation injury and is persistently beneficial for pulmonary surfactant in lung transplants.

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