Pulmonary preservation with LPD and celsior solution in porcine lung transplantation after 24 h of cold ischemia.
OBJECTIVE
Pulmonary preservation for transplantation is associated with ischemia reperfusion injury resulting in endothelial cell and surfactant dysfunction. The purpose of the study was to compare two extracellular type solutions, low potassium dextrane (LPD) and Celsior in their ability of ameliorating lung ischemia reperfusion injury.


METHODS
In 12 donor pigs, the left lung was perfused with either LPD (n = 6) or Celsior (n = 6) solution. After 24 h cold storage, the lungs were transplanted into 12 recipient animals. After reperfusion of the left lung, the right pulmonary artery and bronchus were clamped. Bronchoalveolar lavage fluid (BALF) was obtained before the surgical procedure and 2 h after reperfusion. Surfactant activity was measured from BALF using a pulsating bubble surfactometer. Hemodynamic and respiratory parameters were assessed in 30-min intervals for 7 post-operative hours.


RESULTS
In both study groups two of six animals died from severe ischemia reperfusion injury, thus survival did not differ between groups. Rise of pulmonary vascular resistance index (P = 0.01) and sequestration of neutrophiles (P = 0.08) was less pronounced in Celsior group when compared to LPD animals. A difference in surfactant activity between both groups was not evident after 2 h of reperfusion.


CONCLUSIONS
Both solutions might provide safe pulmonary preservation for 24 h of cold ischemia. While surfactant activity was affected to the same extent in both groups, Celsior solution provided slightly superior endothelial preservation.
Sommer
Sebastian P
SP
Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, 30623 Hannover, Germany.
Warnecke
Gregor
G
Hohlfeld
Jens M
JM
Gohrbandt
Bernhard
B
Niedermeyer
Jost
J
Kofidis
Theodoros
T
Haverich
Axel
A
Strüber
Martin
M
D000818:Animals; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D003080:Cold Temperature; D003911:Dextrans; D004187:Disaccharides; D004573:Electrolytes; D005260:Female; D005947:Glucose; D005971:Glutamates; D005978:Glutathione; D006439:Hemodynamics; D006639:Histidine; D008168:Lung; D016040:Lung Transplantation / Q000473:pathology / Q000502:physiology*; D008353:Mannitol; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions; D009195:Peroxidase / Q000378:metabolism; D011654:Pulmonary Edema / Q000209:etiology; D015427:Reperfusion Injury / Q000517:prevention & control; D012143:Respiratory Physiological Phenomena; D013499:Surface Properties; D013552:Swine
C088453:Celsior; D003911:Dextrans; D004187:Disaccharides; D004573:Electrolytes; D005971:Glutamates; D019188:Organ Preservation Solutions; C083290:low potassium dextran glucose solution; D008353:Mannitol; D006639:Histidine; D009195:Peroxidase; D005978:Glutathione; D005947:Glucose