Background/Purpose:

Ex-vivo Lung perfusion (EVLP) is a tool for evaluation and reconditioning of extended criteria donor lungs. In this study Custodiol-N, originally designed to prevent free-radical induced damage during cold static organ preservation, was used as an EVLP solution for the first time.

Aim:

The aim of this study was to examine if the modified Custodiol-N solution is feasible for EVLP.

Methods:

Lungs were harvested after cardiac arrest and 30 min of ischaemia. After a 9h cold storage preservation, group 1 of donor lungs (N=8) was perfused with Custodiol-N + dextran, while Group 2 (N=8) was additionally perfused with albumin for four hours. Lung tissue was prepared for microscopy, examining the alveolar septum density. In addition, CD11a-Antibody-fluorescence and a TUNEL-Assay were reviewed. The oxygenation capacity, lactate and lactate dehydrogenase-concentration were assessed.

Results:

The lungs were well-preserved, alveolar septum density per lung on average 27.6%. As markers for cell damage: average apoptosis per bronchus 0.53, per alveolus 0.27 or lymphocyte-infiltrations: average lymphocytes per bronchus 0.1, per alveolus 0.26 were recognized. These values did not significantly differ from those observed in control lungs that were immediately fixed after cardiac arrest.  There was no difference in oxygenation capacity, lactate or latctate dehydrogenase concentration between the groups.

Conclusions:

Modified Custodiol-N seems to be a feasible perfusion solution for the ex-vivo lung perfusion. Histology of the lung tissue and laboratory tests did not show an advantage in adding albumin to the solution.