Abstract

Objective: The poor tolerance of the lung to ischemia and reperfusion (ER) represents the major limitation in clinically successful lung transplantation. Euro-Collins (EC) is routinely used in lung preservation, but alternative solutions have been developed for improvement of pulmonary preservation. Celsior® is an extracellular solution which has significantly reduced the ER-induced pulmonary damage in animal studies. So far no larger experimental studies exist concerning the influence of Celsior® on pulmonary gas exchange following ER.

Method: In an extracorporeal rat lung model 10 lungs, each, were preserved with Celsior® (CE) and Celsior®/prostacycline (CEPC, 6 µg/100 ml) at 4 and 15°C, each, and compared to low-potassium-Euro-Collins (LPEC, 40 mmol/l). After two hours of ischemia lungs were re-ventilated and reperfused with blood-containing Krebs-Henseleit solution using a roller-pump. Relative oxygenation capacity (ROC), pulmonary vascular resistance (PVR), peak inspiratory pressure and wet/dry ratio were monitored for 50 minutes. Statistical analysis was performed using ANOVA.

Results: ROC of all Celsior preserved organs was significantly higher as compared to the EC group (p < 0.02). Isolated application of prostacyclin or increase of perfusate temperature did not have any significant effect on ROC. However, after combined Celsior alteration in terms of prostacyclin admixture at 15°C, a superior ROC was observed (p < 0.01). The lowest PVR was found in the CE 4°C group (p < 0.02).

Conclusions: Celsior® provides better lung preservation than LPEC solution. Application of prostacyclin at higher perfusate temperatures results in additional functional improvement. In vivo experiments and ultrastructural analysis are warranted for further evaluation of Celsior in lung preservation.