Improved metabolism and redox state with a novel preservation solution: implications for donor lungs after cardiac death (DCD)
AuthorSchipper, David A.
Louis, Anthony V.
Dicken, Destiny S.
Smolenski, Ryszard T.
Black, Stephen M.
Garcia, Joe G.N.
AffiliationUniv Arizona, Coll Med, Dept Surg, Div Cardiothorac Surg
Univ Arizona, Coll Med, Div Translat & Regenerat Med, Dept Med
Univ Arizona, Hlth Sci Ctr
MetadataShow full item record
PublisherSAGE PUBLICATIONS INC
CitationImproved metabolism and redox state with a novel preservation solution: implications for donor lungs after cardiac death (DCD) 2017, 7 (2):494 Pulmonary Circulation
Rights© The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License.
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AbstractLungs donated after cardiac death (DCD) are an underutilized resource for a dwindling donor lung transplant pool. Our study investigates the potential of a novel preservation solution, Somah, to better preserve statically stored DCD lungs, for an extended time period, when compared to low-potassium dextran solution (LPD). We hypothesize that Somah is a metabolically superior organ preservation solution for hypothermic statically stored porcine DCD lungs, possibly improving lung transplant outcomes. Porcine DCD lungs (n = 3 per group) were flushed with and submerged in cold preservation solution. The lungs were stored up to 12 h, and samples were taken from lung tissue and the preservation medium throughout. Metabolomic and redox potential were analyzed using high performance liquid chromatography, mass spectrometry, and RedoxSYS (R), comparing substrate and pathway utilization in both preservation solutions. Glutathione reduction was seen in Somah but not in LPD during preservation. Carnitine, carnosine, and n-acetylcarnosine levels were elevated in the Somah medium compared with LPD throughout. Biopsies of Somah exposed lungs demonstrated similar trends after 2 h, up to 12 h. Adenosine gradually decreased in Somah medium over 12 h, but not in LPD. An inversely proportional increase in inosine was found in Somah. Higher oxidative stress levels were measured in LPD. Our study suggests suboptimal metabolic preservation in lungs stored in LPD. LPD had poor antioxidant potential, cytoprotection, and an insufficient redox potential. These findings may have immediate clinical implications for human organs; however, further investigation is needed to evaluate DCD lung preservation in Somah as a viable option for transplant.
Note12 month embargo; First Published May 24, 2017
VersionFinal published version
SponsorsUS-Polish Fulbright Commission