A new preservation solution for lung transplantation: evaluation in a porcine transplantation model.
BACKGROUND
Lung preservation injury is still a major problem in lung transplantation. The aim of the current study was to evaluate the effects of a new preservation solution (Custodiol-N) for lung preservation.


METHODS
Using an in vivo pig model, 7 lungs each were preserved for 24 hours after perfusion with: low-potassium dextran (LPD) solution as control (Group I); base solution of Custodiol-N without iron chelators (Group II); Custodiol-N (Group III); or Custodiol-N supplemented with dextran 40 (Group IV). Four animals received a sham operation. After left lung transplantation and contralateral lung exclusion, hemodynamics and blood gases were monitored for 6 hours; tissue samples were taken at the end of the experiments.


RESULTS
All animals survived the transplantation procedure. Base solution- and Custodiol-N-preserved lungs (Groups II and III) showed graft function similar to that of LPD-preserved lungs (Group I), showing a trend toward improved values. Custodiol-N with dextran (Group IV) led to a significant reduction of mean pulmonary arterial pressure (20 ± 2 vs 28 ± 3 mm Hg, p < 0.01) and pulmonary vascular resistance (410 ± 51 vs 588 ± 83 dyne/s/cm(5), p < 0.01), and oxygenation ratio was significantly higher (536 ± 52 vs 313 ± 107 mm Hg at 6 hours, p < 0.01) and PCO(2) values were significantly lower (51 ± 9 vs 77 ± 5 mm Hg at 6 hours, p < 0.01) at 6 hours compared with LPD (Group I). Custodiol-N (Groups II to IV) showed a trend toward a lower wet/dry ratio and reduced oxidative stress; in the presence of dextran (Group IV), the difference was again statistically significant, when compared with LPD (Group I).


CONCLUSIONS
Custodiol-N solution is a new alternative preservation solution for lung transplantation that offers significantly superior protection compared with LPD when dextran 40 is added.
Department of Thoracic and Cardiovascular Surgery, West German Heart Center, University Hospital Essen, Essen, Germany. nikolaus.pizanis@uk-essen.de
Nikolaus
N
Pizanis
Andrey
A
Petrov
Jens
J
Heckmann
Ingrid
I
Wiswedel
Jeremias
J
Wohlschläger
Herbert
H
de Groot
Heinz
H
Jakob
Ursula
U
Rauen
Markus
M
Kamler
D000818:Animals; D001784:Blood Gas Analysis; D003911:Dextrans / Q000494:pharmacology; D005947:Glucose / Q000494:pharmacology; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D008168:Lung / Q000187:drug effects* / Q000473:pathology / Q000502:physiology*; D016040:Lung Transplantation; D008297:Male; D023421:Models, Animal; D009926:Organ Preservation / Q000379:methods; D019188:Organ Preservation Solutions / Q000494:pharmacology*; D015427:Reperfusion Injury / Q000517:prevention & control; D013552:Swine
C549285:Custodiol-N solution; D003911:Dextrans; D019188:Organ Preservation Solutions; C083290:low potassium dextran glucose solution; D005947:Glucose