Prevention of ischemia-reperfusion lung injury during static cold preservation by supplementation of standard preservation solution with HEMOlifein pig lung transplantation model.

Abstract

We describe the results of adding a new biological agent HEMOlifeto a standard preservation solution for hypothermic static lung preservation aiming to improve early functional parameters after lung transplantation. HEMOlifeis a natural oxygen carrier extracted from Arenicola marina with high oxygen affinity developed as an additive to standard organ preservation solutions. Standard preservation solution (Perfadex) was compared with Perfadexassociated with HEMOlifeand with sham animals after 24&#x2009;h of hypothermic preservation followed by lung transplantation. During five hours of lung reperfusion, functional parameters and biomarkers expression in serum and in bronchoalveolar lavage fluid (BALF) were measured. After five hours of reperfusion, HEMOlifegroup led to significant improvement in functional parameters: reduction of graft vascular resistance (p&#x2009;<&#x2009;.05) and increase in graft oxygenation ratio (p&#x2009;<&#x2009;.05). Several ischemia-reperfusion related biomarkers showed positive trends in the HEMOlifegroup: expression of HMG B1 in serum tended to be lower in comparison (2.1&#x2009;&#xb1;&#x2009;0.8 vs. 4.6&#x2009;&#xb1;&#x2009;1.5) with Perfadexgroup, TNF-&#x3b1; and IL-8 in BALF were significantly higher in the two experimental groups compared to control (p&#x2009;<&#x2009;.05). During cold ischemia, expression of HIF1&#x3b1; and histology remained unchanged and similar to control. Supplementation of the Perfadexsolution by an innovative oxygen carrier HEMOlifeduring hypothermic static preservation improves early graft function after prolonged cold ischemia in lung transplantation.