Comparison of Ex Vivo Lung Perfusion, With or Without Albumin, With Static Cold Storage in a Rat Ex Vivo Lung Perfusion Model.

Ex vivo lung perfusion is an alternative to static cold storage for lung preservation in clinical lung transplantation. This study aimed to compare ex vivo lung perfusion with an acellular solution versus static cold storage and to assess the role of albumin as an additive to the acellular perfusion solution. Rat heart-lung blocks from Sprague-Dawley rats, after 1 hour of warm ischemia, were immersed in a low-potassium dextran solution for another hour. Blocks were then placed on ex vivo lung perfusion for 3 hours, with or without the addition of 70 g/L of albumin. Parameters such as gas exchange, dynamic lung compliance, and pulmonary vascular resistance were evaluated every 30 minutes. Control lungs were preserved in low-potassium dextran solution at 4 °C for 4 hours (static cold storage group). Lung injury was assessed using wet-to-dry ratio, histology, immunohistochemistry, and TUNEL assay. Pulmonary vascular resistance significantly decreased between 30 and 60 minutes of ex vivo lung perfusion, whereas other lung function parameters remained stable throughout the 3 hours. No significant differences were observed between the ex vivo lung perfusion and ex vivo lung perfusion + albumin groups in terms of lung function or pathology assessment. Pathological findings indicated that ex vivo lung perfusion, with or without albumin, resulted in increased edema and apoptotic activity compared with lungs preserved by static cold storage. The addition of albumin to the ex vivo lung perfusion solution did not result in significant improvements in functional parameters or pathological findings.