@article {Boys235, author = {Joshua A. Boys and Michael E. Bowdish and Ram Kumar Subramanyan and Kimberly~A. Shemanski and Gundeep S. Dhillon and Koichi Toda and Johanna Perrillo and Leonardo Seoane and Michael J. Bates and P. Eugene Parrino and Hannah Kooperkamp and Vincent~G. Valentine and W. Brooks Emory and John L. Ochsner and P. Michael McFadden}, title = {Fortification of Preservation Solution With Nitroprusside Does Not Alter Lung Allograft Survival in Clinical Human Lung Transplantation}, volume = {19}, number = {3}, pages = {235--240}, year = {2019}, doi = {10.31486/toj.19.0027}, publisher = {Ochsner Journal}, abstract = {Background: Nitric oxide improves gas exchange following primary lung allograft dysfunction. Nitroprusside, a potent nitric oxide donor, has reduced reperfusion injury and improved oxygenation in experimental lung transplantation.Methods: We sought to study the effect on lung allograft outcomes of fortifying the preservation solution with nitroprusside. We conducted a single-center clinical study of 46 consecutive lung recipients between 1998 and 2000: 24 patients received donor organs preserved in modified Euro-Collins solution with prostaglandin E1 (PGE1) (control group), and 22 patients received organs preserved in modified Euro-Collins with PGE1 and nitroprusside (NP group). The primary endpoint was overall survival.Results: Baseline characteristics were similar between the groups except for a significantly longer graft ischemic time in the NP group vs the control group (253.3 {\textpm} 52 vs 225.3 {\textpm} 41 minutes, respectively, P=0.04). No significant differences were found in partial pressure arterial oxygen to fraction inspired oxygen ratio at <=48 hours, primary graft dysfunction, or bronchiolitis obliterans{\textendash}free days. Overall survival at 1, 3, and 5 years was 89\%, 73\%, and 63\% in the control group and 76\%, 38\%, and 23\% in the NP group. Log-rank survival analysis showed that the NP group had a significantly increased risk of mortality (P=0.034) compared to the control group.Conclusion: The addition of nitroprusside to the lung transplant perfusate in this clinical trial did not improve survival; however, a large randomized trial would likely reduce confounding ischemia times and increase the power of the study.}, issn = {1524-5012}, URL = {https://www.ochsnerjournal.org/content/19/3/235}, eprint = {https://www.ochsnerjournal.org/content/19/3/235.full.pdf}, journal = {Ochsner Journal} }