Source: Annual Congress 2012 - Lung transplantation: studies in candidates and recipients

Abstract

Objectives: Scot15® is a low-K+ preservation solution including polyethylene glycol (PEG) as a colloid for protection of vascular endothelium during cold ischemia. PEG was previously demonstrated to have "immunocamouflage" properties. The aim of this study was to assess whether these properties would be beneficial in a pig lung transplant model.
Material: Domestic pig donor lungs were flushed either with Scot15®[S;n=6] or Perfadex®[P;n=6] and stored on ice for 22 hours. The left lung was transplanted in a recipient animal observed during 6 hours after reperfusion. Pulmonary vascular resistance (PVR) and partial arterial oxygen tension (PaO₂) were measured hourly. Lung biopsies were taken for HRMAS detection of the respective colloid in the lungs. Bronchoalveolar lavage (BAL) was taken to assess neutrophilic alveolar recruitment. At the end of reperfusion, wet to dry weight ratio (W/D) was measured as a marker of lung edema.
Results: HRMAS showed presence of PEG in the lungs in [S] before and during the reperfusion. Dextran was not detected in [P]. After 6 hours of reperfusion, PaO₂ was significantly better in [S](310±51mmHg versus 198±71mmHg in [P];p=0.03). PVR remained lower in [S] but the difference did not reach significance. Differential cell count of BAL showed lower neutrophilic cell count in [S](89±67neutrophils in [S] versus 139±53neutrophils in [P];p=0.001). There was no difference in W/D weight ratio (p=0.9).
Conclusion: After 22 hours of cold ischemia, oxygenation capacity was superior with less inflammatory reaction in lung grafts preserved with Scot15®. Further experiments to study the "immunocamouflage" properties of PEG based solutions in lungs are warranted.

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A. Olland, A. Neyrinck, M. Benhamed, T. Boogmans, A. Stanzi, K. Elbayed, S. Wauters, G. Verleden, I. Namer, D. Van Raemdonck (Leuven, Belgium; Strasbourg, France). Superior lung preservation with a polyethylene glycol based solution in a porcine lung transplant model. Eur Respir J 2012; 40: Suppl. 56, 1484

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