Impact of preservation solution on the extent of blood-air barrier damage and edema formation in experimental lung transplantation.
A major aim in lung transplantation is to prevent the loss of structural integrity due to ischemia and reperfusion (I/R) injury. Preservation solutions protect the lung against I/R injury to a variable extent. We compared the influence of two extracellular-type preservation solutions (Perfadex, or PX, and Celsior, or CE) on the morphological alterations induced by I/R. Pigs were randomly assigned to sham (n = 4), PX (n = 5), or CE (n = 2) group. After flush perfusion with PX or CE, donor lungs were excised and stored for 27 hr at 4 degrees C. The left donor lung was implanted into the recipient, reperfused for 6 hr, and, afterward, prepared for light and electron microscopy. Intra-alveolar, septal, and peribronchovascular edema as well as the integrity of the blood-air barrier were determined stereologically. Intra-alveolar edema was more pronounced in CE (219.80 +/- 207.55 ml) than in PX (31.46 +/- 15.75 ml). Peribronchovascular (sham: 13.20 +/- 4.99 ml; PX: 15.57 +/- 5.53 ml; CE: 31.56 +/- 5.78 ml) and septal edema (thickness of alveolar septal interstitium, sham: 98 +/- 33 nm; PX: 84 +/- 8 nm; CE: 249 +/- 85 nm) were only found in CE. The blood-air barrier was similarly well preserved in sham and PX but showed larger areas of swollen and fragmented epithelium or endothelium in CE. The present study shows that Perfadex effectively prevents intra-alveolar, septal, and peribronchovascular edema formation as well as injury of the blood-air barrier during I/R. Celsior was not effective in preserving the lung from morphological I/R injury.
Mühlfeld
Christian
C
Institute of Anatomy, University of Bern, Bern, Switzerland. christian.muehlfeld@ana.unibe.ch
Müller
Katharina
K
Pallesen
Lars-Peder
LP
Sandhaus
Tim
T
Madershahian
Navis
N
Richter
Joachim
J
Wahlers
Thorsten
T
Wittwer
Thorsten
T
Ochs
Matthias
M
D000818:Animals; D015824:Blood-Air Barrier / Q000187:drug effects* / Q000648:ultrastructure; D002951:Citrates / Q000494:pharmacology; D004187:Disaccharides / Q000494:pharmacology; D004573:Electrolytes / Q000494:pharmacology; D005971:Glutamates / Q000494:pharmacology; D005978:Glutathione / Q000494:pharmacology; D006639:Histidine / Q000494:pharmacology; D008168:Lung / Q000098:blood supply / Q000187:drug effects* / Q000648:ultrastructure; D016040:Lung Transplantation / Q000379:methods*; D008353:Mannitol / Q000494:pharmacology; D046529:Microscopy, Electron, Transmission; D023421:Models, Animal; D009926:Organ Preservation / Q000009:adverse effects / Q000379:methods*; D019188:Organ Preservation Solutions / Q000494:pharmacology* / Q000627:therapeutic use; D011654:Pulmonary Edema / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D011897:Random Allocation; D015427:Reperfusion Injury / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D013552:Swine
C088453:Celsior; D002951:Citrates; D004187:Disaccharides; D004573:Electrolytes; D005971:Glutamates; D019188:Organ Preservation Solutions; C070005:Perfadex; D008353:Mannitol; D006639:Histidine; D005978:Glutathione