PT - JOURNAL ARTICLE AU - Boys, Joshua A. AU - Bowdish, Michael E. AU - Subramanyan, Ram Kumar AU - Shemanski, Kimberly A. AU - Dhillon, Gundeep S. AU - Toda, Koichi AU - Perrillo, Johanna AU - Seoane, Leonardo AU - Bates, Michael J. AU - Parrino, P. Eugene AU - Kooperkamp, Hannah AU - Valentine, Vincent G. AU - Emory, W. Brooks AU - Ochsner, John L. AU - McFadden, P. Michael TI - Fortification of Preservation Solution With Nitroprusside Does Not Alter Lung Allograft Survival in Clinical Human Lung Transplantation AID - 10.31486/toj.19.0027 DP - 2019 Sep 21 TA - Ochsner Journal PG - 235--240 VI - 19 IP - 3 4099 - http://www.ochsnerjournal.org/content/19/3/235.short 4100 - http://www.ochsnerjournal.org/content/19/3/235.full SO - Ochsner J2019 Sep 21; 19 AB - 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.