Celsior solution for improvement of currently used clinical standards of lung preservation in an ex vivo rat model.
OBJECTIVE
The introduction of Euro-Collins solution with its intracellular electrolyte composition has allowed for clinically accepted pulmonary preservation for up to 7 h of ischemic time. In recent years several alternative solutions have been developed for the improvement of pulmonary preservation. Celsior is an extracellular solution which has significantly reduced the ischemia/reperfusion (IR)-induced pulmonary damage in animal studies. So far, no larger experimental studies exist concerning the influence of Celsior on pulmonary gas exchange following IR.


METHODS
In an extracorporeal rat lung model ten lungs, were each preserved with Celsior (CE) and Celsior/ prostacycline (CEPC, 6 mg/100 ml) at 4 degrees C and compared with preservation with low-potassium-Euro-Collins solution (LPEC, 40 mmol/l of potassium). After 2 h of ischemia the lungs were re-ventilated and reperfused using a roller-pump. Relative oxygenation capacity (ROC), pulmonary vascular resistance (PVR), peak inspiratory pressure (PIP) and wet/dry ratio were monitored for 50 min. Statistical analysis was performed using ANOVA.


RESULTS
ROC was increased in all Celsior preserved organs compared with the EC group (P < 0.032). Though the CEPC group was found to have the lowest PIP and the least amount of lung water as assessed by wet/dry ratio, PVR was highest after 30-50 min. The significantly lowest PVR was determined in the CE group (P < 0.02).


CONCLUSIONS
Celsior provides better lung preservation than LPEC solution, as demonstrated by a significantly increased oxygenation ability, a lower PVR and a decreased wet/ dry ratio. In vivo experiments and additional histological analysis are warranted for further evaluation of Celsior in lung preservation.
Wittwer
T
T
Division of Cardiovascular and Vascular Surgery, Medical School Hannover, Germany. Th.Wittwer-MD@t-online.de
Wahlers
T
T
Cornelius
J F
JF
Elki
S
S
Haverich
A
A
D000704:Analysis of Variance; D000818:Animals; D004187:Disaccharides; D004195:Disease Models, Animal; D004573:Electrolytes; D005112:Extracorporeal Circulation; D005971:Glutamates; D005978:Glutathione; D006639:Histidine; D016040:Lung Transplantation / Q000379:methods* / Q000502:physiology*; D008297:Male; D008353:Mannitol; D009926:Organ Preservation / Q000592:standards*; D019188:Organ Preservation Solutions; D010101:Oxygen Consumption; D051381:Rats; D017207:Rats, Sprague-Dawley; D012016:Reference Values; D012680:Sensitivity and Specificity; D014655:Vascular Resistance
C088453:Celsior; D004187:Disaccharides; D004573:Electrolytes; D005971:Glutamates; D019188:Organ Preservation Solutions; D008353:Mannitol; D006639:Histidine; D005978:Glutathione