title: Comparison of extracellular-type-Kyoto solution and Perfadex as a preservation solution in a pig ex vivo lung perfusion model: impact of potassium level.
abstract: BACKGROUND
  The ex vivo lung perfusion (EVLP) system has been used successfully to assess donor lungs. Perfadex (PX) is usually the flush and preservation solution in EVLP systems. We have used the extracellular-type-Kyoto (ET-K) solution containing 44 mEq/L potassium for clinical lung transplantation, investigating whether it rather than PX affects the EVLP system.
  
  
  METHODS
  We used domestic slaughterhouse pigs to analyze the EVLP system. After 20-minute warm ischemia and 6-hour cold ischemia, EVLP was performed for 2 hours. Pig heart-lung blocks were divided into the PX (n = 5) and ET-K (n = 5) groups depending on the flush/cold preservation solution. At the beginning, we discarded the first 100 mL of effluent in the PX group and the first 200 mL in the ET-K group. We measured pulmonary physiological data and potassium levels.
  
  
  RESULTS
  In both groups, perfusion for 2 hours showed no differences between the 2 groups with respect to the final flow, pulmonary arterial pressure, pulmonary vascular resistance, PaO(2)/FiO(2), and shunt fraction. The potassium level in the perfusate was 4.4 mEq/L for the PX and 5.4 mEq/L for the ET-K group.
  
  
  CONCLUSIONS
  The pig EVLP system was not affected when ET-K was used instead of PX as the flush/preservation solution. The initial 200 mL of effluent should be discarded when using the ET-K to ensure that the potassium level does not increase.
authors.affiliation: Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Okamoto
authors.forename: F
authors.initials: F
authors.lastname: Chen
authors.forename: J
authors.initials: J
authors.lastname: Zhang
authors.forename: H
authors.initials: H
authors.lastname: Choi
authors.forename: T
authors.initials: T
authors.lastname: Yamada
authors.forename: H
authors.initials: H
authors.lastname: Morikawa
authors.forename: E
authors.initials: E
authors.lastname: Nakayama
authors.forename: T
authors.initials: T
authors.lastname: Bando
authors.forename: H
authors.initials: H
authors.lastname: Date
mesh_terms: D000818:Animals; D002951:Citrates; D066298:In Vitro Techniques; D008168:Lung; D023421:Models, Animal; D019188:Organ Preservation Solutions; D011188:Potassium / Q000032:analysis*; D013552:Swine
chemical_list: D002951:Citrates; D019188:Organ Preservation Solutions; C070005:Perfadex; D011188:Potassium