TY - JOUR T1 - Fortification of Preservation Solution With Nitroprusside Does Not Alter Lung Allograft Survival in Clinical Human Lung Transplantation JF - Ochsner Journal JO - Ochsner J SP - 235 LP - 240 DO - 10.31486/toj.19.0027 VL - 19 IS - 3 AU - Joshua A. Boys AU - Michael E. Bowdish AU - Ram Kumar Subramanyan AU - Kimberly A. Shemanski AU - Gundeep S. Dhillon AU - Koichi Toda AU - Johanna Perrillo AU - Leonardo Seoane AU - Michael J. Bates AU - P. Eugene Parrino AU - Hannah Kooperkamp AU - Vincent G. Valentine AU - W. Brooks Emory AU - John L. Ochsner AU - P. Michael McFadden Y1 - 2019/09/21 UR - http://www.ochsnerjournal.org/content/19/3/235.abstract N2 - 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 ± 52 vs 225.3 ± 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–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. ER -