TY - JOUR

T1 - A new preservation solution for lung transplantation

T2 - Evaluation in a porcine transplantation model

AU - Pizanis, Nikolaus

AU - Petrov, Andrey

AU - Heckmann, Jens

AU - Wiswedel, Ingrid

AU - Wohlschlger, Jeremias

AU - De Groot, Herbert

AU - Jakob, Heinz

AU - Rauen, Ursula

AU - Kamler, Markus

N1 - Funding Information: U.R. and H.d.G. are consultants of Dr. Franz Köhler Chemie GmbH (Bensheim, Germany). None of the other authors have any conflicts of interest to disclose. This study was funded in part by a grant from Dr. Franz Köhler Chemie . The design, performance, data interpretation and manuscript preparation was under the complete control of the authors and not influenced by the sponsoring company. The authors thank Karin Kaiser for excellent technical assistance. N.P. received a grant from the medical faculty of the University of Essen (IFORES Program).

PY - 2012/3

Y1 - 2012/3

N2 - Background: Lung preservation injury is still a major problem in lung transplantation. The aim of the current study was to evaluate the effects of a new preservation solution (Custodiol-N) for lung preservation. Methods: Using an in vivo pig model, 7 lungs each were preserved for 24 hours after perfusion with: low-potassium dextran (LPD) solution as control (Group I); base solution of Custodiol-N without iron chelators (Group II); Custodiol-N (Group III); or Custodiol-N supplemented with dextran 40 (Group IV). Four animals received a sham operation. After left lung transplantation and contralateral lung exclusion, hemodynamics and blood gases were monitored for 6 hours; tissue samples were taken at the end of the experiments. Results: All animals survived the transplantation procedure. Base solution and Custodiol-Npreserved lungs (Groups II and III) showed graft function similar to that of LPD-preserved lungs (Group I), showing a trend toward improved values. Custodiol-N with dextran (Group IV) led to a significant reduction of mean pulmonary arterial pressure (20 ± 2 vs 28 ± 3 mm Hg, p < 0.01) and pulmonary vascular resistance (410 ± 51 vs 588 ± 83 dyne/s/cm 5, p < 0.01), and oxygenation ratio was significantly higher (536 ± 52 vs 313 ± 107 mm Hg at 6 hours, p < 0.01) and PCO 2 values were significantly lower (51 ± 9 vs 77 ± 5 mm Hg at 6 hours, p < 0.01) at 6 hours compared with LPD (Group I). Custodiol-N (Groups II to IV) showed a trend toward a lower wet/dry ratio and reduced oxidative stress; in the presence of dextran (Group IV), the difference was again statistically significant, when compared with LPD (Group I). Conclusions: Custodiol-N solution is a new alternative preservation solution for lung transplantation that offers significantly superior protection compared with LPD when dextran 40 is added.

AB - Background: Lung preservation injury is still a major problem in lung transplantation. The aim of the current study was to evaluate the effects of a new preservation solution (Custodiol-N) for lung preservation. Methods: Using an in vivo pig model, 7 lungs each were preserved for 24 hours after perfusion with: low-potassium dextran (LPD) solution as control (Group I); base solution of Custodiol-N without iron chelators (Group II); Custodiol-N (Group III); or Custodiol-N supplemented with dextran 40 (Group IV). Four animals received a sham operation. After left lung transplantation and contralateral lung exclusion, hemodynamics and blood gases were monitored for 6 hours; tissue samples were taken at the end of the experiments. Results: All animals survived the transplantation procedure. Base solution and Custodiol-Npreserved lungs (Groups II and III) showed graft function similar to that of LPD-preserved lungs (Group I), showing a trend toward improved values. Custodiol-N with dextran (Group IV) led to a significant reduction of mean pulmonary arterial pressure (20 ± 2 vs 28 ± 3 mm Hg, p < 0.01) and pulmonary vascular resistance (410 ± 51 vs 588 ± 83 dyne/s/cm 5, p < 0.01), and oxygenation ratio was significantly higher (536 ± 52 vs 313 ± 107 mm Hg at 6 hours, p < 0.01) and PCO 2 values were significantly lower (51 ± 9 vs 77 ± 5 mm Hg at 6 hours, p < 0.01) at 6 hours compared with LPD (Group I). Custodiol-N (Groups II to IV) showed a trend toward a lower wet/dry ratio and reduced oxidative stress; in the presence of dextran (Group IV), the difference was again statistically significant, when compared with LPD (Group I). Conclusions: Custodiol-N solution is a new alternative preservation solution for lung transplantation that offers significantly superior protection compared with LPD when dextran 40 is added.

KW - dextran

KW - iron chelator

KW - ischemia/reperfusion injury

KW - lipid peroxidation

KW - lung transplantation

KW - preservation solution

KW - ROS

UR - http://www.scopus.com/inward/record.url?scp=84857058416&partnerID=8YFLogxK

U2 - 10.1016/j.healun.2011.11.009

DO - 10.1016/j.healun.2011.11.009

M3 - Article

C2 - 22226803

AN - SCOPUS:84857058416

VL - 31

SP - 310

EP - 317

JO - Journal of Heart and Lung Transplantation

JF - Journal of Heart and Lung Transplantation

SN - 1053-2498

IS - 3

ER -