A Novel Controlled Cold Storage System for Optimal Lung Preservation

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Purpose Currently the on-ice method is the standard technique used to transport lungs for transplantation. This involves placing the organ in preservation solution and subsequently in a cooler filled with ice. This method is imprecise, difficult to monitor and results in temperatures below 2° C. These temperatures impair mitochondrial activity, damage pulmonary endothelium and can potentially lead to primary and/or long-term graft dysfunction. The objective of this study was to compare the standard on-ice technique to a controlled rate cooling system using the LUNGguard (Paragonix) device to maintain an organ temperature of 4° to 8° C. Methods Porcine lungs were procured and preserved for 1, 2, 4 and 6 hours (according to clinical protocol). For each time point, two sets of lungs were preserved using the standard on-ice technique and the LUNGguard device. Temperatures were measured with thermal surface imaging at the beginning and the end of each run. Results In the traditional on-ice preservation method the temperature dropped from 2.3° to -1.3° C after 6 hours. Controlled rate storage using the LUNGguard device was able to maintain organ temperatures between 4° and 8° C across all time periods. Conclusion The studied controlled rate cooling system offers a consistent hypothermic preservation method for the lungs between 4° to 8° C. This ideal and consistent storage temperature may reduce mitochondrial and endothelial cell damage of donor lungs and prevent primary and long-term graft failure. Currently the on-ice method is the standard technique used to transport lungs for transplantation. This involves placing the organ in preservation solution and subsequently in a cooler filled with ice. This method is imprecise, difficult to monitor and results in temperatures below 2° C. These temperatures impair mitochondrial activity, damage pulmonary endothelium and can potentially lead to primary and/or long-term graft dysfunction. The objective of this study was to compare the standard on-ice technique to a controlled rate cooling system using the LUNGguard (Paragonix) device to maintain an organ temperature of 4° to 8° C. Porcine lungs were procured and preserved for 1, 2, 4 and 6 hours (according to clinical protocol). For each time point, two sets of lungs were preserved using the standard on-ice technique and the LUNGguard device. Temperatures were measured with thermal surface imaging at the beginning and the end of each run. In the traditional on-ice preservation method the temperature dropped from 2.3° to -1.3° C after 6 hours. Controlled rate storage using the LUNGguard device was able to maintain organ temperatures between 4° and 8° C across all time periods. The studied controlled rate cooling system offers a consistent hypothermic preservation method for the lungs between 4° to 8° C. This ideal and consistent storage temperature may reduce mitochondrial and endothelial cell damage of donor lungs and prevent primary and long-term graft failure.