Effect of Warm Perfusion of Donor Lungs Using the OCS on Immune Mediator Release during Preservation

Abstract

Purpose Warm perfusion of donor lungs for transplantation (Tx) using Organ Care System® (OCS) may provide superior preservation compared to standard cold preservation (SOC). Release and composition of donor-derived soluble immune mediators (IM), triggering allorecognition and inflammation after Tx, might be differentially affected. We analyzed 55 soluble IM in the respective preservation solutions (PS), as well as in peripheral blood (PB) of the recipient. Methods and Materials IM were quantified at protein level (pg/ml) by Luminex-based multiplex-technology in PS at the end of cold storage (SOC, n=11) or warm preservation in OCS (n=13), either based on low potassium dextrane solution. Differences were assessed using Mann-Whitney-U and ROC / AUC statistics. Results Unexpectedly huge differences were found between concentrations in PS, extrapolating to several μg for large volume of PS (1.0– 1.5l). We focus on those 20 factors displaying highest statistical differences with higher release in OCS: IL-6 p Conclusions Donor-derived IM remained low in SOC, whereas OCS potentially depleted them from the organ with accumulation in PS. This ‘dialysis’ effect may indicate anti-inflammatory properties. Further studies on clinical outcomes of patients transplanted with OCS vs. SOC preserved lungs are warranted.