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Articles in PresS, published online ahead of print August 2, 2002
J Appl Physiol, 10.1152/jap.00252.2002
Submitted on March 26, 2002
Accepted on July 22, 2002
1 Division of Allergy, Pulmonary and Critical Care, Vanderbilt University School of Medicine, Nashville, TN, USA
2 Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA
3 Departments of Medicine and Anesthesia, University of California, San Francisco, CA, USA
4 Thoracic Surgery, Kanazawa University, Kanazawa, Japan
5 Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA; Department of Surgery, University of California, San Francisco, San Francisco, CA, USA
* To whom correspondence should be addressed. E-mail: Lorraine.ware{at}vanderbilt.edu.
Pulmonary edema is common in organ donors and lung transplant recipients. Therefore, we assessed the responsiveness of human donor lungs that were rejected for transplantation to pharmacologic agents that stimulate clearance of alveolar edema. After resection, transport (4°C) and rewarming (37°C), alveolar fluid clearance was measured with (n=8) or without (n=23) beta-adrenergic stimulation. Terbutaline-stimulated (10-4M)was higher than unstimulated clearance (7.1±1.3%/h vs. 4.8±2.4%/h,p<0.01). Preharvest administration of dopamine in low to moderate doses was associated with faster alveolar fluid clearance (r=0.62,p<0.01). Preharvest administration of diuretics was associated with lower extravascular lung water-to-dry weight ratios. This study provides the first evidence that a beta-adrenergic agonist can stimulate alveolar fluid clearance in the human donor lung. Aerosolized beta-adrenergic agonists may have therapeutic value for hastening the resolution of alveolar edema during the management of donors prior to lung resection for transplantation, or in the post-transplant setting.
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