6. Two-Day Lung Preservation Followed by Lung Transplantation in a Large Animal Model Using Novel Extracellular Oxygen Carrier
- Ali1, Y. Watanabe1, M. Galasso1, et al, J Heart Lung Transplant. 37, 45, April 2018, Suppl S123-4
To date, reliable cold static lung preservation (CSP) strategies are limited to 12h as longer times have been associated with impaired graft function. Even though lungs are stored inflated with O2, this poor performance is possibly related to poor oxygen availability and transfer at low temperatures, accumulation of reactive oxygen species, and cellular death. HEMO2Life® is an O2 therapeutic, which consists of the extracellular O2 carrier of the marine invertebrate Arenicola marina known as Hemarina-M101 (M101). M101 has potent anti-oxidative properties and each molecule can carry up to 156 O2 molecules. The purpose of this study was to investigate the use of M101 during extended CSP.
Donor pigs (28-32kg) were randomly allocated to 2 groups (n=4 per group): 1) CSP (Perfadex®, 40C) and 2) CSP + 1g/L of Hemo2Life®. After 36 hours of CSP, the lungs were evaluated through 12h of normothermic ex vivo lung perfusion (EVLP) and a left single lung transplant performed, followed by 4h of reperfusion.
During EVLP, lung function significantly improved in the treatment group in comparison to the control, as shown by a greater decrease in peak airway pressures (p=0.0360), increased dynamic (p=0.0286) and static (p=0.0294) compliance and greater improvements in lung oxygenation capabilities (p=0.0286) as shown in Figure 1. After 48h of preservation (36h CSP+12h EVLP) and 4 hours of reperfusion post-transplantation, the mean P/F ratio of the graft was 383.1 + 106.5 mmHg in the control group, and 481.5 + 65.3 mmHg in the treatment group (n=3 per group, p=0.40).
HEMO2Life® allowed for greater lung recovery during EVLP performed after extended CSP, and led to improvements in post-lung transplant function. These findings demonstrate that it may be possible effectively extend cold static lung preservation significantly towards making lung transplantation a semi-elective.