Is hypothermic perfusion necessary for preservation of the lung?

In a pig-model of left-sided single lung transplantation (42 animals; donors n=18; recipients n=18; sham-operated animals n=6) we investigated the influence of hypothermic storage alone and compared it to lungs preserved with flush-perfusion, using Euro-Collins-(EC) or low potassium dextran (LPD)-solution. After 18 h of ischemia, metabolic parameters, endothelial integrity and transplant function were evaluated. Simple hypothermic storage led to maintenance of energy - rich compounds, no significant endothelial damage and a good post-transplant function. Flush-perfusion using LPD was associated with an improved endothelial preservation and after transplantation the rise in PVR was less pronounced. The application of EC resulted in a less favorable metabolic, morphological and functional outcome. Despite the fact, that a good transplant function was achieved by all animals only two hours after reperfusion, hypothermic storage may be considered to be a sufficient method in lung preservation.