title: Lung Preservation With Perfadex or Celsior in Clinical Transplantation: A Retrospective Single-Center Analysis of Outcomes.
abstract: BACKGROUND
  Despite improvement of lung preservation by the introduction of low-potassium dextran (LPD) solution, ischemia-reperfusion injury remains a major contributor to early post-lung transplant graft dysfunction and mortality. After favorable experimental data, Celsior solution was used in our clinical lung transplant program. Data were compared with our historic LPD cohort.
  
  
  METHODS
  Between January 2002 and January 2005, 209 consecutive lung transplantations were performed with LPD. These were compared to 208 transplants between February 2005 and September 2007 with Celsior. Endpoints included posttransplant PaO2/FiO2 ratio at different timepoints after intensive care unit (ICU) admission, posttransplant ventilation time, ICU stay and 30-day mortality, follow-up survival, and bronchiolitis obliterans syndrome-free survival.
  
  
  RESULTS
  Ratios of sex, urgency status, type of procedure, length of posttransplant ICU stay, and age did not show significant differences between the 2 groups. Mean ischemia times were significantly longer in the Celsior group (LPD, 355 ± 105 minutes vs Celsior, 436 ± 139 minutes, P < 0.001). Overall 3-year-survival (LPD, 66.5% vs Celsior, 72.0%; P = 0.25) was nonsignificantly improved in the Celsior cohort.
  
  
  CONCLUSIONS
  A trend toward better survival (P = 0.09) and increased freedom from bronchiolitis obliterans syndrome (P = 0.03) was observed in the Celsior group despite prolonged ischemic times compared with LPD. Lung preservation with Celsior is safe and effective and may carry advantages.
authors: 1 Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany. 2 Department of Cardiovascular and Thoracic Surgery, Medical Centre of the Johannes Gutenberg University, Mainz, Germany. 3 Department of Heart and Lung Transplantation/VAD, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom. 4 Department of Thoracic Surgery and Lung Support, Ibbenbueren General Hospital, Ibbenbueren, Germany. 5 Department of Cardiac Surgery, University Hospital Munich, Munich, Germany. 6 Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany. 7 Department of Cardiac Surgery, University of Leipzig-Heart Centre, Leipzig, Germany.
authors: Bernhard
authors: B
authors: Gohrbandt
authors: Andre R
authors: AR
authors: Simon
authors: Gregor
authors: G
authors: Warnecke
authors: Stefan
authors: S
authors: Fischer
authors: Christian
authors: C
authors: Hagl
authors: Adelheid
authors: A
authors: Niehaus
authors: Jens
authors: J
authors: Gottlieb
authors: Tobias
authors: T
authors: Welte
authors: Axel
authors: A
authors: Haverich
authors: Martin
authors: M
authors: Strueber
mesh_terms: D000328:Adult; D001988:Bronchiolitis / Q000517:prevention & control; D002951:Citrates / Q000009:adverse effects / Q000627:therapeutic use*; D004187:Disaccharides / Q000009:adverse effects / Q000627:therapeutic use; D018572:Disease-Free Survival; D004573:Electrolytes / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005858:Germany; D005971:Glutamates / Q000009:adverse effects / Q000627:therapeutic use; D005978:Glutathione / Q000009:adverse effects / Q000627:therapeutic use; D006639:Histidine / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007362:Intensive Care Units; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D016040:Lung Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D008297:Male; D008353:Mannitol / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D009926:Organ Preservation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D019188:Organ Preservation Solutions / Q000009:adverse effects / Q000627:therapeutic use*; D055031:Primary Graft Dysfunction / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D016016:Proportional Hazards Models; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: C088453:Celsior; D002951:Citrates; D004187:Disaccharides; D004573:Electrolytes; D005971:Glutamates; D019188:Organ Preservation Solutions; C070005:Perfadex; D008353:Mannitol; D006639:Histidine; D005978:Glutathione