title: Do we need to cool the lung graft after ex vivo lung perfusion? A preliminary study.
abstract: BACKGROUND
  After normothermic ex vivo lung perfusion (EVLP), pulmonary grafts are usually flush-cooled and stored on ice until implantation although evidence for this practice lacks. We compared outcomes between 2 post-EVLP preservation strategies in a porcine left single-lung transplantation model.
  
  
  METHODS
  After cold flush and 2-h EVLP, donor lungs were prepared and split. In [C], (n = 5) lungs cooled on device to 15°C were preserved in ice-water; in [W] (n = 5), lungs were disconnected from EVLP at 37°C and kept at room temperature. The left lung was transplanted in a recipient animal. Posttransplant, 6 h-monitoring included hourly assessment of pulmonary vascular resistance, pulmonary artery pressure, plateau airway pressure, compliance, and oxygenation before and after exclusion of the right lung. Lung biopsies and bronchoscopy with bronchoalveolar lavage (BAL) were performed at retrieval, at the end of EVLP (R lung), and 1 and 6 h after reperfusion (L lung).
  
  
  RESULTS
  Lungs in [W] showed the highest compliance (P < 0.05) and the lowest plateau airway pressure (not statistically significant) throughout the whole reperfusion period. Oxygenation and pulmonary artery pressure were similar between groups. Pulmonary vascular resistance was stable in [C], but rose after reperfusion in [W]. Histologic signs of lung injury and BAL neutrophilia were more pronounced in [C] at 1 h (not statistically significant and P < 0.05, respectively). BAL cytokine levels and lung tissue expression of intercellular adhesion molecule 1 did not differ between groups.
  
  
  CONCLUSIONS
  Normothermic preparation after EVLP results in similar graft performances compared with lung cooling after EVLP.
authors.affiliation: Laboratory for Experimental Thoracic Surgery, Department of Clinical and Experimental Medicine, KU Leuven University, Leuven, Belgium; Department of Thoracic Surgery, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Stanzi
authors.affiliation: Laboratory for Experimental Thoracic Surgery, Department of Clinical and Experimental Medicine, KU Leuven University, Leuven, Belgium; Department of Anesthesia, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Arne
authors.initials: A
authors.lastname: Neyrinck
authors.affiliation: Laboratory for Experimental Thoracic Surgery, Department of Clinical and Experimental Medicine, KU Leuven University, Leuven, Belgium.
authors.forename: Jana
authors.initials: J
authors.lastname: Somers
authors.affiliation: Department of Anesthesia, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Hans
authors.initials: H
authors.lastname: Cauwenberghs
authors.affiliation: Department of Pathology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Eric
authors.initials: E
authors.lastname: Verbeken
authors.affiliation: Department of Thoracic Surgery, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Santambrogio
authors.affiliation: Laboratory for Experimental Thoracic Surgery, Department of Clinical and Experimental Medicine, KU Leuven University, Leuven, Belgium; Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium. Electronic address: dirk.vanraemdonck@uzleuven.be.
authors.forename: Dirk
authors.initials: D
authors.lastname: Van Raemdonck
mesh_terms: D000818:Animals; D001831:Body Temperature; D001992:Bronchoalveolar Lavage Fluid; D002951:Citrates / Q000494:pharmacology; D015925:Cryopreservation / Q000379:methods*; D005112:Extracorporeal Circulation / Q000379:methods; D006085:Graft Survival; D016040:Lung Transplantation / Q000379:methods* / Q000401:mortality; D008297:Male; D023421:Models, Animal; D019188:Organ Preservation Solutions / Q000494:pharmacology; D010477:Perfusion / Q000379:methods*; D010865:Pilot Projects; D013552:Swine
chemical_list: D002951:Citrates; D019188:Organ Preservation Solutions; C070005:Perfadex
keywords: Ex vivo lung perfusion; Flush; Lung transplantation; Temperature