Donation and Procurement Posters

Tuesday July 03, 2018 from 16:30 to 17:30

Room: Hall 10 - Exhibition

P.638 Common hospital ingredient perfusate equivalent to standard krebs–henseleit buffer with serum albumin derived perfusate in negative pressure ventilation ex vivo lung perfusion

Max T Buchko, Canada

Cardiac Surgery Resident
Department of Cardiac Surgery
University of Alberta

Abstract

Common Hospital Ingredient Perfusate Equivalent to Standard Krebs–Henseleit Buffer with Serum Albumin Derived Perfusate in Negative Pressure Ventilation Ex Vivo Lung Perfusion

Max Buchko1,2, Sayed Himmet1, Catherine J Stewart1, Nader S Aboelnazar1, Sanaz Hatami1, Darren H Freed1,2,3,4, Jayan Nagendran1,2,3,4.

1Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada; 2Mazankowski Alberta Heart Institute, Edmonton, AB, Canada; 3Alberta Transplant Institute, Edmonton, AB, Canada; 4Canadian National Transplant Research Program, Edmonton, AB, Canada

Introduction: Normothermic ex-vivo lung perfusion (EVLP) using negative pressure ventilation (NPV) and red blood cell-based perfusate solutions have been shown to decrease edema formation and pro-inflammatory cytokine production compared to positive pressure ventilation (PPV).  We sought to develop a common hospital ingredient derived perfusate (CHIP) with equivalent functional and inflammatory characteristics to the standard Krebs–Henseleit buffer with 8% serum albumin derived perfusate (KHB-Alb) in order to improve access and reduce costs of ex vivo organ perfusion.
Methods: Porcine lungs were perfused using NPV-EVLP for 12 hours in a normothermic state, and were allocated to two groups: KHB-Alb (n=8) vs CHIP (n=4). Physiologic parameters, cytokine profiles, and edema formation were compared between treatment groups.
Results: Perfused lungs in both groups demonstrated equivalent oxygenation (partial pressure of arterial oxygen/ fraction of inspired oxygen ratio >350 mmHg) and physiologic parameters. There was equivalent generation of tumor necrosis factor-α, irrespective of perfusate solution used, when comparing CHIP vs KHB-Alb. Pig lungs developed equivalent edema formation between groups (CHIP: 15.7 ± 5.8%, STEEN 19.5 ± 4.4%, p>0.05).
Conclusion:A perfusate derived of common hospital ingredients provides equivalent results to standard Krebs–Henseleit buffer with 8% serum albumin based perfusate in NPV-EVLP.

Canadian Institutes for Health Research - Canadian National Transplant Research Program (CIHR-CNTRP). University Hospital Foundation (UHF). Mazankowski Alberta Heart Institute - University Hospital Foundation Gerald Averback Award in Cardiovascular Gene Therapy / Genomics and Vascular Biology.



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