title: Comparison of lung preservation solutions in human lungs using an ex vivo lung perfusion experimental model.
abstract: OBJECTIVE
  Experimental studies on lung preservation have always been performed using animal models. We present ex vivo lung perfusion as a new model for the study of lung preservation. Using human lungs instead of animal models may bring the results of experimental studies closer to what could be expected in clinical practice.
  
  
  METHODS
  Brain-dead donors whose lungs had been declined by transplantation teams were used. The cases were randomized into two groups. In Group 1, Perfadex®was used for pulmonary preservation, and in Group 2, LPDnac, a solution manufactured in Brazil, was used. An ex vivo lung perfusion system was used, and the lungs were ventilated and perfused after 10 hours of cold ischemia. The extent of ischemic-reperfusion injury was measured using functional and histological parameters.
  
  
  RESULTS
  After reperfusion, the mean oxygenation capacity was 405.3 mmHg in Group 1 and 406.0 mmHg in Group 2 (p = 0.98). The mean pulmonary vascular resistance values were 697.6 and 378.3 dyn·s·cm-5, respectively (p =0.035). The mean pulmonary compliance was 46.8 cm H20 in Group 1 and 49.3 ml/cm H20 in Group 2 (p =0.816). The mean wet/dry weight ratios were 2.06 and 2.02, respectively (p=0.87). The mean Lung Injury Scores for the biopsy performed after reperfusion were 4.37 and 4.37 in Groups 1 and 2, respectively (p = 1.0), and the apoptotic cell counts were 118.75/mm² and 137.50/mm², respectively (p=0.71).
  
  
  CONCLUSIONS
  The locally produced preservation solution proved to be as good as Perfadex®. The clinical use of LPDnac may reduce costs in our centers. Therefore, it is important to develop new models to study lung preservation.
authors.affiliation: Heart Institute, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Israel L
authors.initials: IL
authors.lastname: Medeiros
authors.forename: Paulo M
authors.initials: PM
authors.lastname: Pêgo-Fernandes
authors.forename: Alessandro W
authors.initials: AW
authors.lastname: Mariani
authors.forename: Flávio G
authors.initials: FG
authors.lastname: Fernandes
authors.forename: Fernando V
authors.initials: FV
authors.lastname: Unterpertinger
authors.forename: Mauro
authors.initials: M
authors.lastname: Canzian
authors.forename: Fabio B
authors.initials: FB
authors.lastname: Jatene
mesh_terms: D000328:Adult; D002452:Cell Count; D002951:Citrates / Q000737:chemistry; D050377:Cold Ischemia; D005453:Fluorescence; D006801:Humans; D008168:Lung; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions; D010477:Perfusion / Q000379:methods*; D015427:Reperfusion Injury / Q000473:pathology; D013997:Time Factors; D014019:Tissue Donors
chemical_list: D002951:Citrates; D019188:Organ Preservation Solutions; C070005:Perfadex