title: Comparison between cellular and acellular perfusates for ex vivo lung perfusion in a porcine model.
abstract: BACKGROUND
  Ex vivo lung perfusion with acellular solutions is an established technique for assessing marginal donor lungs. We evaluated the utility of a blood-based lung preservation fluid as an alternative perfusate.
  
  
  METHODS
  Donor lungs from 50-kg donation after cardiac death pigs (n = 24) were randomized into 3 groups: acellular, commercial blood-based, and Papworth-Blood. Physiologic function was evaluated using conventional markers of pulmonary vascular resistance, pulmonary compliance, lactate excretion, partial pressure of oxygen/fraction of inspired oxygen, and wet-to-dry ratios. The immunologic profile was assessed by fluorescence-activated cell sorting analysis of bronchoalveolar lavage and cells entrapped in the leucocyte filter. Cytokines were quantified using a commercial platform.
  
  
  RESULTS
  No significant difference was noted in pulmonary vascular resistance (p = 0.26), compliance (p = 0.12), partial pressure of oxygen/fraction of inspired oxygen (p = 0.06) and wet-to-dry ratios (p = 0.26) between groups. There was no difference between the percentages of lymphocytes (p = 0.51), macrophages (p = 0.87), monocytes (p = 0.68), and dendritic cells (p = 0.65) in the leukocyte filters. Interleukin (IL)-1β (p = 0.36), IL-6 (p = 0.08), IL-8 (p = 0.64), and IL-18 (p = 0.14) were elevated in all groups. In bronchoalveolar lavage, IL-8 was significantly higher in the acellular group (p = 0.04). Electron microscopy cell characteristics were similar among the groups.
  
  
  CONCLUSIONS
  This study demonstrated no significant difference in the physiologic, immunologic, or ultrastructural parameters between lungs perfused with cellular or acellular solutions. The Papworth-Blood solution is a potential alternative perfusate for ex vivo lung perfusion.
authors.affiliation: Department of Cardiothoracic Transplantation, Papworth Hospital, Cambridge, United Kingdom. Electronic address: mariusroman@nhs.net.
authors.forename: Marius
authors.initials: M
authors.lastname: Roman
authors.affiliation: Department of Surgery, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Olivera
authors.initials: O
authors.lastname: Gjorgjimajkoska
authors.affiliation: Department of Histopathology and Electron Microscopy, Queen Elizabeth Hospital, Birmingham, United Kingdom.
authors.forename: Desley
authors.initials: D
authors.lastname: Neil
authors.affiliation: Department of Cardiothoracic Transplantation, Papworth Hospital, Cambridge, United Kingdom.
authors.forename: Sukumaran
authors.initials: S
authors.lastname: Nair
authors.affiliation: Department of Cardiothoracic Transplantation, Papworth Hospital, Cambridge, United Kingdom.
authors.forename: Simon
authors.initials: S
authors.lastname: Colah
authors.affiliation: Department of Cardiothoracic Transplantation, Papworth Hospital, Cambridge, United Kingdom.
authors.forename: Jasvir
authors.initials: J
authors.lastname: Parmar
authors.affiliation: Department of Cardiothoracic Transplantation, Papworth Hospital, Cambridge, United Kingdom.
authors.forename: Steven
authors.initials: S
authors.lastname: Tsui
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D005112:Extracorporeal Circulation / Q000379:methods*; D005434:Flow Cytometry; D016040:Lung Transplantation / Q000379:methods*; D008962:Models, Theoretical; D009926:Organ Preservation / Q000379:methods*; D010477:Perfusion / Q000379:methods*; D013552:Swine
keywords: Ex vivo lung perfusion; cellular immunology; electron microscopy; lung transplantation; organ perfusion; perfusates