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Eur J Cardiothorac Surg 1999;15:667-671
© 1999 Elsevier Science NL

Celsior solution for improvement of currently used clinical standards of lung preservation in an ex vivo rat model¹

Division of Cardiothoracic and Vascular Surgery, Medical School Hannover, Carl–Neuberg-Strasse 1, 30625 Hannover, Germany

Received 21 September 1998; received in revised form 18 January 1999; accepted 27 January 1999.

Corresponding author. Tel.: +49-511-532-6580; fax: +49-511-532-5404; e-mail: Th.Wittwer-MD@t-online.de

Objective: The introduction of Euro–Collins solution with its intracellular electrolyte composition has allowed for clinically accepted pulmonary preservation for up to 7 h of ischemic time. In recent years several alternative solutions have been developed for the improvement of pulmonary preservation. Celsior® is an extracellular solution which has significantly reduced the ischemia/reperfusion (IR)-induced pulmonary damage in animal studies. So far, no larger experimental studies exist concerning the influence of Celsior on pulmonary gas exchange following IR. Methods: In an extracorporeal rat lung model ten lungs, were each preserved with Celsior (CE) and Celsior/prostacycline (CEPC, 6 mg/100 ml) at 4°C and compared with preservation with low-potassium-Euro–Collins solution (LPEC, 40 mmol/l of potassium). After 2 h of ischemia the lungs were re-ventilated and reperfused using a roller-pump. Relative oxygenation capacity (ROC), pulmonary vascular resistance (PVR), peak inspiratory pressure (PIP) and wet/dry ratio were monitored for 50 min. Statistical analysis was performed using ANOVA. Results: ROC was increased in all Celsior preserved organs compared with the EC group (P<0.032). Though the CEPC group was found to have the lowest PIP and the least amount of lung water as assessed by wet/dry ratio, PVR was highest after 30–50 min. The significantly lowest PVR was determined in the CE group (P<0.02). Conclusions: Celsior provides better lung preservation than LPEC solution, as demonstrated by a significantly increased oxygenation ability, a lower PVR and a decreased wet/dry ratio. In vivo experiments and additional histological analysis are warranted for further evaluation of Celsior in lung preservation.

Key Words: Lung transplantation • Preservation solution • Stereological analysis • Ischemia/reperfusion injury

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