Carolin Olbertz1,2, Nikolaus Pizanis1, Hagen Bäumker1, Katharina Kalka1, Clemens Aigner3, Ursula Rauen4, Ingo Nolte2, Markus Kamler1, Achim Koch1. 1. Thoracic Transplantation, Department of Thoracic and Cardiovascular Surgery, West German Heart Center, University Hospital Essen Essen, Germany. 2. Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation Hannover, Germany. 3. Department of Thoracic Surgery University Hospital Essen Essen, Germany. 4. Institute of Physiological Chemistry, University Hospital Essen Essen, Germany.
Abstract
OBJECTIVES: Ex vivo Lung Perfusion (EVLP) is a promising tool to increase the donor pool for lung transplantation. Custodiol-N solution was originally designed for organ preservation during cold static preservation (CSP) and was successfully used for machine perfusion in kidneys. It was the aim of this study to compare the lung functional outcomes after 4 hours of EVLP using modified Custodiol-N or STEEN SolutionTM as perfusion solution. METHODS: In a porcine DCD model, lungs were perfused either with STEEN SolutionTM (Standard SS, n=8) or modified Custodiol-N with added 1.1 g/l glucose monohydrate and 50 g/l dextran 40 (CD, n=8). For a third group 7 g/l albumin was supplemented to modified Custodiol-N (CDA, n=8). During four hours of EVLP pulmonary gas exchange and activities of lactate dehydrogenase (LDH) and alkaline phosphatase (AP) in perfusate were recorded. RESULTS: Lungs that underwent EVLP with modified Custodiol-N showed significantly higher oxygen capacity (ΔpO2 averaged over four hours of EVLP: SS: 236.28 ± 47.26 mmHg, CD: 402.79 ± 30.33 mmHg, CDA: 414.86 ± 9.77 mmHg) than lungs perfused with STEEN SolutionTM. The addition of albumin did not have a significant effect on lung function but these lungs showed lower wet/dry ratio. CONCLUSION: In a porcine DCD model of 9 hours CSP followed by four hours of EVLP the use of modified Custodiol-N as perfusion solution was feasible and associated with higher oxygen capacity than STEEN SolutionTM. The addition of albumin seems to further stabilize lung function. AJTR
OBJECTIVES: Ex vivo Lung Perfusion (EVLP) is a promising tool to increase the donor pool for lung transplantation. Custodiol-N solution was originally designed for organ preservation during cold static preservation (CSP) and was successfully used for machine perfusion in kidneys. It was the aim of this study to compare the lung functional outcomes after 4 hours of EVLP using modified Custodiol-N or STEEN SolutionTM as perfusion solution. METHODS: In a porcine DCD model, lungs were perfused either with STEEN SolutionTM (Standard SS, n=8) or modified Custodiol-N with added 1.1 g/l glucose monohydrate and 50 g/l dextran 40 (CD, n=8). For a third group 7 g/l albumin was supplemented to modified Custodiol-N (CDA, n=8). During four hours of EVLP pulmonary gas exchange and activities of lactate dehydrogenase (LDH) and alkaline phosphatase (AP) in perfusate were recorded. RESULTS: Lungs that underwent EVLP with modified Custodiol-N showed significantly higher oxygen capacity (ΔpO2 averaged over four hours of EVLP: SS: 236.28 ± 47.26 mmHg, CD: 402.79 ± 30.33 mmHg, CDA: 414.86 ± 9.77 mmHg) than lungs perfused with STEEN SolutionTM. The addition of albumin did not have a significant effect on lung function but these lungs showed lower wet/dry ratio. CONCLUSION: In a porcine DCD model of 9 hours CSP followed by four hours of EVLP the use of modified Custodiol-N as perfusion solution was feasible and associated with higher oxygen capacity than STEEN SolutionTM. The addition of albumin seems to further stabilize lung function. AJTR
Authors: Gabriel Loor; Brian T Howard; John R Spratt; Lars M Mattison; Angela Panoskaltsis-Mortari; Roland Z Brown; Tinen L Iles; Carolyn M Meyer; Haylie R Helms; Andrew Price; Paul A Iaizzo Journal: Transplantation Date: 2017-10 Impact factor: 4.939
Authors: Oleg Pak; Akylbek Sydykov; Djuro Kosanovic; Ralph T Schermuly; Alexander Dietrich; Katrin Schröder; Ralf P Brandes; Thomas Gudermann; Natascha Sommer; Norbert Weissmann Journal: Adv Exp Med Biol Date: 2017 Impact factor: 2.622
Authors: Marcelo Cypel; Jonathan C Yeung; Shin Hirayama; Matthew Rubacha; Stefan Fischer; Masaki Anraku; Masaaki Sato; Stephen Harwood; Andrew Pierre; Thomas K Waddell; Marc de Perrot; Mingyao Liu; Shaf Keshavjee Journal: J Heart Lung Transplant Date: 2008-12 Impact factor: 10.247
Authors: Daniel P Mulloy; Matthew L Stone; Ivan K Crosby; Damien J Lapar; Ashish K Sharma; David V Webb; Christine L Lau; Victor E Laubach; Irving L Kron Journal: J Thorac Cardiovasc Surg Date: 2012-08-31 Impact factor: 5.209
Authors: Roberto Carnevale; Giuseppe Biondi-Zoccai; Mariangela Peruzzi; Elena De Falco; Isotta Chimenti; Federico Venuta; Marco Anile; Daniele Diso; Elena Cavarretta; Antonino G M Marullo; Patrizio Sartini; Pasquale Pignatelli; Francesco Violi; Giacomo Frati Journal: Oxid Med Cell Longev Date: 2014-04-16 Impact factor: 6.543