Effect of Preservation Solution on Graft Viability in Single-Lung Transplantation From Heart-Beating Donors in Pigs

Abstract

Background Low-potassium-dextran preservation solution Perfadex (PER) may provide better outcome of transplanted lungs than high-potassium Euro-Collins (EC) solution. However, there are no comparative studies of the recipient inflammatory response to the graft. Purpose The purpose of this study was to compare EC versus PER as preservation solutions with respect to the functional performance and inflammatory response in single-lung transplantation from heart-beating donors in pigs. Materials and Methods The donor left lung flushed with the corresponding cold preservation solution was stored at 3°C for 3 hours. We assessed hemodynamic values and pulmonary function in the recipient over a 2-hour reperfusion period calculated as percent of basal values, and expressed as mean of the reperfusion period. Interleukin-8 (IL-8) concentration in the donor was estimated in bronchoalveolar lavage fluid 2 hours after recipient reperfusion. Biopsies of the donor right lung and the transplanted lung were obtained to measure myeloperoxidase (MPO) activity. IL-8 and MPO values were expressed as percent of the donor value. We evaluated the wet/dry pulmonary weight ratio (W/D), polymorphonuclear neutrophil count (PMN), and a score of histological damage in the transplanted graft. Results Pulmonary function evaluated by % static: 66.6 ± 6.8 (EC), 82.3 ± 10.2 (PER), and dynamic: 74.0 ± 7.3 (EC), 89.3 ± 7.7 (PER) compliances, as well as % IL-8: 562.5 ± 168.6 (EC), 232.3 ± 148.7 (PER), % MPO: 485.9 ± 194.9 (EC), 140.8 ± 21.1 (PER), W/D: 9.9 ± 3.1 (EC), 6.8 ± 1.4 (PER), PMN 13.5 ± 6.8 (EC), 5.5 ± 3.3 (PER) and the histological damage score: 3.0 ± 1.5 (EC), 0.7 ± 0.4 (PER) showed significant differences between the EC and the PER ( P < .01). Conclusions PER affords good lung preservation with early graft function and modest evidences of inflammation, lung injury, and edema compared with the EC perfused lung.