A major aim in
lung transplantation is to prevent the loss of structural integrity due to
ischemia and reperfusion (I/R) injury. Preservation solutions protect the lung against I/R injury to a variable extent. We compared the influence of two extracellular-type preservation solutions (
Perfadex, or PX, and
Celsior, or CE) on the morphological alterations induced by I/R. Pigs were randomly assigned to
sham (n = 4), PX (n = 5), or CE (n = 2) group. After flush perfusion with PX or CE, donor lungs were excised and stored for 27 hr at 4 degrees C. The left donor lung was implanted into the recipient, reperfused for 6 hr, and, afterward, prepared for light and electron microscopy. Intra-alveolar, septal, and peribronchovascular
edema as well as the integrity of the blood-air barrier were determined stereologically. Intra-alveolar
edema was more pronounced in CE (219.80 +/- 207.55 ml) than in PX (31.46 +/- 15.75 ml). Peribronchovascular (
sham: 13.20 +/- 4.99 ml; PX: 15.57 +/- 5.53 ml; CE: 31.56 +/- 5.78 ml) and septal
edema (thickness of alveolar septal interstitium,
sham: 98 +/- 33 nm; PX: 84 +/- 8 nm; CE: 249 +/- 85 nm) were only found in CE. The blood-air barrier was similarly well preserved in
sham and PX but showed larger areas of swollen and fragmented epithelium or endothelium in CE. The present study shows that
Perfadex effectively prevents intra-alveolar, septal, and peribronchovascular
edema formation as well as injury of the blood-air barrier during I/R.
Celsior was not effective in preserving the lung from morphological I/R injury.