Dynamics of Nitroglycerin-induced Exhaled Nitric Oxide After Lung Transplantation: Evidence of Pulmonary Microvascular Injury?

Janos Gal, Tamas Kovesi, David Royston, Nándor Marczin

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: In search of real-time molecular correlates to ischemia-reperfusion-induced lung injury, we explored the hypothesis that liberation of nitric oxide (NO) into exhaled breath after pulmonary microvascular bioconversion of nitroglycerin (GTN) is attenuated in clinical lung transplantation. Methods: Exhaled NO was measured under basal conditions and after intravenous administration of GTN in patients undergoing lung transplantation. Patients undergoing routine cardiac surgery served as controls. Basal and GTN-induced exhaled NO was also measured in donors before retrieval and after implantation in recipients. Results: The characteristic GTN-induced exhaled NO response observed in cardiac surgical patients before cardiopulmonary bypass and in lung transplant and multiple-organ donors was nearly totally abolished in lung transplant recipients. This response was also attenuated to a lesser degree in the routine cardiac surgery patients after cardiopulmonary bypass. Conclusions: These results suggest a graded influence of time-factored complete and partial ischemia on GTN-induced evolution of NO into exhaled breath, providing biochemical evidence for a degree of microvascular injury, which can be monitored non-invasively at the bedside.

Original languageEnglish
Pages (from-to)1300-1305
Number of pages6
JournalJournal of Heart and Lung Transplantation
Volume26
Issue number12
DOIs
Publication statusPublished - Dec 1 2007

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

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