Feasibility of Lung Hypothermic Perfusion Without Ventilation: An Experimental Study

Area of Science:

• Transplantation research
• Organ preservation techniques
• Surgical innovation

Background:

• Hypothermic machine perfusion (HMP) is a standard for preserving abdominal organ grafts.
• Its efficacy for lung preservation is not yet established.
• Static cold storage (SCS) is the current lung preservation method.

Purpose of the Study:

• To evaluate HMP as an alternative to SCS for lung preservation.
• To investigate the feasibility and outcomes of HMP in a lung model.
• To compare HMP with SCS in swine lung preservation.

Main Methods:

• A paired-lung model using swine lungs (n=14) was employed.
• Lungs were randomly assigned to 6-hour SCS (4°C) or pressure-controlled HMP (10°C).
• Preservation was assessed via graft weight, wet/dry ratio, imaging, histology, and biomarkers.

Main Results:

• HMP was technically feasible, maintaining lung temperature.
• HMP induced significantly greater interstitial edema compared to SCS.
• Elevated lactate, CO2, and Interleukin-12/23p40 were observed in HMP perfusate.

Conclusions:

• HMP for lung grafts is feasible but leads to significant edema without ventilation/oxygenation.
• Directly applying HMP protocols from other organs to lungs requires modifications.
• Strategies to prevent graft edema are necessary for successful lung HMP.