A comparison of the new preservation solution Celsior to Euro-Collins and University of Wisconsin solutions in lung reperfusion injury

Background. The lung is particularly susceptible to reperfusion injury, bot h experimentally and clinically after transplantation. The extracellular-ty pe preservation solution Celsior, which has been predominantly studied in c ardiac preservation, has components designed to prevent cell swelling, free radical injury, energy depletion, and calcium overload. Using an isolated blood-perfused rat lung model, we investigated whether Celsior would decrea se preservation injury and improve lung function after cold ischemic storag e and reperfusion compared to Euro-Collins (EC) and University of Wisconsin (UW) solutions. Methods. Lewis rat lungs were isolated, flushed with the respective cold pr eservation solution, and then stored at 4 degrees C for 6 or 12 hr, After i schemic storage, the lung block was suspended from a force transducer, vent ilated with 100% O-2, and reperfused for 90 min with fresh blood via a cann ula in the pulmonary artery. Lung compliance, alveolar-arterial oxygen diff erence, and outflow oxygen tension were all measured. The capillary filtrat ion coefficient (K-f), a sensitive measure of changes in microvascular perm eability, was determined. Results. For 6 hr of cold storage, lungs stored in Celsior had lower K-f va lues than those stored in EC, indicating decreased microvascular permeabili ty, No other significant differences were noted between Celsior and EC or U W. For 12 hr of cold storage, Celsior provided increased oxygenation, decre ased alveolar-arterial O-2 differences, increased compliance, and decreased K-f values as compared to both EC and UW. Conclusions. Celsior provides better lung preservation than EC or UW as dem onstrated by increased oxygenation, decreased capillary permeability, and i mproved lung compliance, particularly at 12-hr storage times. These results are highly relevant, inasmuch as EC and UW are the most common clinically used lung preservation solutions. Further studies of Celsior in experimenta l and clinical lung transplantation, as well as in other solid organs, are indicated.