Perfadex for clinical lung procurement: is it an advance?
BACKGROUND
Extensive laboratory experience suggested that low potassium dextran lung preservation solution (Perfadex; Medisan, Uppsala, Sweden) is superior to Euro-Collins (EC; Frusen, Hamburg, Germany), the clinical standard. The purpose of this study was to evaluate Perfadex in clinical lung transplantation.


METHODS
A retrospective analysis of the outcome of 69 consecutive lung allografts retrieved and used for transplantation was made. Donor lungs were flushed with EC in 37 patients and Perfadex in 32 patients. The evaluation measurements were quantitative chest roentgenogram score (grade 0 to 4), graft oxygenation, duration of mechanical ventilation, length of intensive care treatment, and survival.


RESULTS
The mean chest roentgenogram score was 1.55 and 1.81 for the EC group compared with 1.18 and 2.09 for the Perfadex group at 1 and 48 hours, respectively (p = 0.1 and 0.8, respectively). Arterial alveolar oxygen tension ratio was similar at 12 and 24 hours (0.61 vs 0.67; p = 0.8; and 0.64 vs 0.53; p = 0.3, respectively). The mean ventilation time was 71.2 +/- 32.3 hours versus 81.9 +/- 43.6 hours for the EC and Perfadex groups, respectively (p = 0.4). The mean intensive therapy unit stay was 3.1 +/- 2.6 days for the EC group compared with 4.1 +/- 3.9 days for the Perfadex group (p = 0.4). Death caused by primary organ failure was 5.1% for the EC group compared with 3.1% for the Perfadex group (p = 0.8).


CONCLUSIONS
There was no difference between Perfadex and EC in clinical lung preservation. This may reflect the difference between controlled laboratory environment and the real world of brain death lung injury. Further studies are required to investigate the impact of Perfadex in the long-term outcome of lung transplantation.
Aziz
Tarek M
TM
Transplant Unit Freeman Hospital, Newcastle-Upon-Tyne, United Kingdom.
Pillay
Thaseegaran M
TM
Corris
Paul A
PA
Forty
Jonathan
J
Hilton
Colin J
CJ
Hasan
Asif
A
Dark
John H
JH
D002423:Cause of Death; D002951:Citrates; D006801:Humans; D016040:Lung Transplantation / Q000401:mortality / Q000502:physiology*; D008432:Mathematical Computing; D009926:Organ Preservation; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology*; D011659:Pulmonary Gas Exchange / Q000502:physiology*; D012131:Respiratory Insufficiency / Q000401:mortality / Q000503:physiopathology; D012189:Retrospective Studies; D015996:Survival Rate; D009927:Tissue and Organ Procurement
D002951:Citrates; C070005:Perfadex