LATE BREAKING I

D. Nakajima, T. Yamada, F. Chen, J. Sakamoto, F. Kojima, A. Ohsumi, T. Fujinaga, T. Shoji, H. Sakai, T. Bando, H. Date
Thoracic Surgery, Kyoto University, Kyoto/JAPAN

Body: Introduction. To resolve the shortage of donor lungs, the use of non-heart-beating donors (NHBD) has come into practice. An ideal method of preservation that can improve the quality of NHBD lungs has been investigated. Hypothermic machine perfusion has been widely used to preserve kidneys for transplantation with better results than static cold storage. Therefore, we investigated whether hypothermic ex vivo perfusion can improve the quality of NHBD lungs. Methods. Male Lewis rats were used. Ninety minutes after cardiac arrest induced by ventricular fiblliration, hypothermic ex vivo lung perfusion (HEVLP) was performed using Low Potassium Dextran solution with serum albumin for 60 minutes at 6-10 ℃. The first study investigated the physiological lung function during HEVLP and the lung tissue energy levels before and after HEVLP. In the second study, the rats were allocated into 3 groups (n=6 each): no ischemia (Group I); 90 minutes warm ischemia + 60 minutes HEVLP + 120 minutes static cold storage (Group II); 90 minutes warm ischemia + 180 minutes static cold storage (Group III). In all groupes, lungs were reperfused for 60 minutes at 37 ℃ by an isolated rat lung perfusion model, in which lung functions were evaluated on time during reperfusion. Results. Lung functions (pulmonary compliance, airway resistance, mean pulmonary artery pressure, lung weight) were stable during HEVLP. Lung tissue energy levels decreased during warm ischemia (TAN 4.31, ATP 1.03, ADP 0.81 nmol/mg), but significantly increased by HEVLP (TAN 5.93, ATP 2.64, ADP 1.12 nmol/mg, p<0.05). During reperfusion, HEVLP significantly decreased airway resistance, shunt fraction and pulmonary vascular resistance. HEVLP also significantly increased pulmonary compliance and oxygenation. Conclusions. Short-term hypothermic ex vivo lung perfusion improved lung tissue energy levels which decreased during warm ischemia, and prevented ischemia reperfusion injury.

Disclosure: All authors have declared no conflicts of interest.