Effect of perfusion pH on rat lung viability of non-heart beating donors

Abstract

Lung tissue is not susceptible to the 'pH paradox' observed in liver preservation studies. Because more than 80% of lung cells are still viable 4 h after death if the lungs are ventilated with 100% O2 during the cadaveric period, retrieval and transplantation of cadaveric lungs may be feasible and might alleviate the paucity of lung donors.

The lung and carbon dioxide: implications for permissive and therapeutic hypercapnia

“…Thus, gradual rather than rapid restoration of intracellular pH while cells become re-oxygenated minimises the cellular injury associated with ischaemia-reperfusion. This effect has been labelled the "pH paradox" and was first described for the heart and liver [28][29][30][31][32], but subsequently has also been shown in lung, kidney and brain [33][34][35][36][37][38]. This paradigm led LAFFEY et al [39] to take permissive hypercapnia one step further by deliberately adding CO 2 to the ventilating gas of ischaemic lungs in vivo.…”