title: Argon and xenon ventilation during prolonged ex vivo lung perfusion.
abstract: BACKGROUND
  Evidence supports the use of ex vivo lung perfusion (EVLP) as a platform for active reconditioning before transplantation to increase the potential donor pool and to reduce the incidence of primary graft dysfunction. A promising reconditioning strategy is the administration of inhaled noble gases based on their organoprotective effects. Our aim was to validate a porcine warm ischemic lung injury model and investigate postconditioning with argon (Ar) or xenon (Xe) during prolonged EVLP.
  
  
  METHODS
  Domestic pigs were divided in four groups (n = 5 per group). In the negative control group, lungs were flushed immediately. In the positive control (PC) and treatment (Ar, Xe) groups, lungs were flushed after a warm ischemic interval of 2-h in situ. All grafts were evaluated and treated during normothermic EVLP for 6 h. In the control groups, lungs were ventilated with 70% N2/30% O2 and in the treatment groups with 70% Ar/30% O2 or 70% Xe/30% O2, respectively. Outcome parameters were physiological variables (pulmonary vascular resistance, peak airway pressures, and PaO2/FiO2), histology, wet-to-dry weight ratio, bronchoalveolar lavage, and computed tomography scan.
  
  
  RESULTS
  A significant difference between negative control and PC for pulmonary vascular resistance, peak airway pressures, PaO2/FiO2, wet-to-dry weight ratio, histology, and computed tomography-imaging was observed. No significant differences between the injury group (PC) and the treatment groups (Ar, Xe) were found.
  
  
  CONCLUSIONS
  We validated a reproducible prolonged 6-h EVLP model with 2 h of warm ischemia and described the physiological changes over time. In this model, ventilation during EVLP with Ar or Xe administered postinjury did not improve graft function.
authors: Laboratory of Anesthesiology and Algology, Department of Cardiovascular Sciences, Katholieke Universiteit Leuven and University Hospitals, Leuven, Belgium; Leuven Lung Transplant Unit, Katholieke Universiteit Leuven, Leuven, Belgium.
authors: An
authors: A
authors: Martens
authors: Leuven Lung Transplant Unit, Katholieke Universiteit Leuven, Leuven, Belgium; Laboratory of Experimental Thoracic Surgery, Department of Clinical and Experimental Medicine, Katholieke Universiteit Leuven and University Hospitals, Leuven, Belgium.
authors: Matteo
authors: M
authors: Montoli
authors: Laboratory of Anesthesiology and Algology, Department of Cardiovascular Sciences, Katholieke Universiteit Leuven and University Hospitals, Leuven, Belgium; Leuven Lung Transplant Unit, Katholieke Universiteit Leuven, Leuven, Belgium.
authors: Giulio
authors: G
authors: Faggi
authors: Air Liquide Santé International Medical R&D Paris-Saclay Research Center, Jouy-en Josas, France.
authors: Ira
authors: I
authors: Katz
authors: Air Liquide Santé International Medical R&D Paris-Saclay Research Center, Jouy-en Josas, France.
authors: Jan
authors: J
authors: Pype
authors: Leuven Lung Transplant Unit, Katholieke Universiteit Leuven, Leuven, Belgium; Laboratory of Pneumology, Department of Clinical and Experimental Medicine, Lung Transplant Unit, Katholieke Universiteit Leuven and University Hospitals, Leuven, Belgium.
authors: Bart M
authors: BM
authors: Vanaudenaerde
authors: Leuven Lung Transplant Unit, Katholieke Universiteit Leuven, Leuven, Belgium; Laboratory of Experimental Thoracic Surgery, Department of Clinical and Experimental Medicine, Katholieke Universiteit Leuven and University Hospitals, Leuven, Belgium.
authors: Dirk E M
authors: DE
authors: Van Raemdonck
authors: Laboratory of Anesthesiology and Algology, Department of Cardiovascular Sciences, Katholieke Universiteit Leuven and University Hospitals, Leuven, Belgium; Leuven Lung Transplant Unit, Katholieke Universiteit Leuven, Leuven, Belgium. Electronic address: arne.neyrinck@uzleuven.be.
authors: Arne P
authors: AP
authors: Neyrinck
mesh_terms: D000818:Animals; D001128:Argon; D006085:Graft Survival; D008168:Lung / Q000276:immunology / Q000473:pathology; D016040:Lung Transplantation; D008297:Male; D010477:Perfusion; D012121:Respiration, Artificial; D012129:Respiratory Function Tests; D013552:Swine; D052096:Warm Ischemia; D014978:Xenon
chemical_list: D014978:Xenon; D001128:Argon
keywords: Argon; Ex vivo lung perfusion; Ischemia–reperfusion injury; Lung transplantation; Noble gases; Xenon