We have investigated the role of erythrocyte (RBC) deformability and perfusate viscosity on lung segmental vascular resistance in 12 isolated perfused lungs of 3- to 5-wk-old rabbits. Each lung was perfused alternately with control and formaldehyde-fixed rabbit RBCs at a flow rate of 80 ml.kg-1.min-1, left atrial and airway pressures being 8 and 6 cmH2O, respectively (zone 3). Perfusate RBC concentration was kept constant at 3.2 x 10(6)/mm3 for group I lungs (n = 6) and 7.2 x 10(6)/mm3 for group II lungs (n = 6). In all lungs, we measured pressures in the pulmonary artery and in 20- to 50-microns-diam arterioles and venules with the micropipette servo-null method during both perfusion periods. Compared with control, fixed cells had a 60% decrease in deformability index (i.e., the volume of a dilute solution of RBCs filtered through a 5-microns Nuclepore filter in 1 min). In groups I and II, perfusate viscosity of fixed cells was 15 and 55% greater, respectively, than that of control cells. We found that perfusion with fixed cells in group I lungs did not alter total or segmental vascular pressure drops. However, in group II lungs, perfusion with fixed cells at twice the cell concentration resulted in an increase in total vascular pressure drop, mainly due to an increase in pressure drop in veins (50% of total) and arteries (33%). The relatively small (17%) increase in pressure drop in microvessels was probably due to distension and/or recruitment of capillaries resulting from increased venular pressures.(ABSTRACT TRUNCATED AT 250 WORDS)