Surfactant pretreatment decreases long-term damage after XXXX -reperfusion injury of the lung.

@entity1008 @entity5721 @entity18895 @entity63 @entity11264 @entity651 @entity891 @entity35
OBJECTIVE: @entity5721 ( @entity5721 ) is a risk factor for primary acute graft failure following lung transplantation. @entity5721 hereby contributes to morbidity and mortality after lung transplantation. We have previously shown that surfactant pretreatment ameliorates @entity5721 up to 1 week after reperfusion. However, the impact of surfactant pretreatment on long-term outcome following @entity5721 is unknown. Therefore, the objective of this study was to investigate the effect of surfactant pretreatment on long-term outcome following @entity5721 . METHODS: Male @entity35 (n=63) were randomized to receive intratracheally administered porcine surfactant (400mg/kg) or no pretreatment. One hour thereafter, animals underwent 120min of warm @entity63 by clamping the bronchus, pulmonary artery and vein of the left lung. A third group was sham-operated; a fourth group served as unoperated controls. Animals were killed on day 30 or 90 after surgery. Arterial oxygenation and lung compliance were determined. Broncho-alveolar lavage fluid (BALf) was collected to assess surfactant function and alveolar protein. Leukocyte infiltration was determined by flowcytometry in BALf, lung tissue and thoracic lymph nodes. Lungs of three animals per group were used for histological assessment. RESULTS: Lung compliance was lower on day 30 and day 90 after @entity5721 than in sham-operated controls (day 30 V(max) 6.1+/-2.1 vs 12.6+/-1.3, day 90 6.9+/-3.0 vs 12.1+/-1.6; C(max) day 30 0.49+/-0.17 vs 1.08+/-0.21, day 90 0.67+/-0.31 vs 1.11+/-0.17). Furthermore, the number of @entity1008 RA(+)-lymphocytes in left lung tissue was decreased on day 90 compared to unoperated animals (230.633+/-96.770 vs 696.347+/-202.909) and the number of macrophages elevated in left BALf on day 90. HE slides of @entity5721 animals were scored as fibroproliferative with moderate @entity891 . Surfactant pretreatment improved lung compliance (V(max) day 30 11.7+/-1.8, day 90 11.1+/-1.2; C(max) day 30 1.04+/-0.23, day 90 1.16+/-0.21) and normalized the number of @entity1008 RA(+)-lymphocytes (769.555+/-421.016) in left lung tissue. Furthermore lung architecture on HE slides was on return to normal. However, more @entity18895 (+) @entity11264 (+)-lymphocytes on day 30 (754.788+/-97.269 vs 430.409+/-109.909) and more macrophages on day 90 (2.144.000+/-630.633 vs 867.454+/-383.220) were measured in pretreated lung tissue compared to @entity5721 animals. CONCLUSIONS: Severe @entity5721 caused extensive @entity651 up to 90 days postoperatively. Surfactant pretreatment normalized pulmonary function, but resulted in an increased number of @entity18895 (+) @entity11264 (+)-cells and macrophages in lung tissue.
