• Alessandro Wasum Mariani, Israel Lopes Medeiros, Paulo Manuel Pêgo-Fernandes, Flavio Guimarães Fernandes, Fernando Do Vale Unterpertinguer, Lucas Matos Fernandes, Paulo Francisco Cardoso, Mauro Canzian, and Fabio Biscegli Jatene.
• Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
• Sao Paulo Med J. 2014 Jan 1; 132 (1): 283528-35.

Context And ObjectiveLung preservation remains a challenging issue for lung transplantation groups. Along with the development of ex vivo lung perfusion, a new preservation method known as topical-ECMO (extracorporal membrane oxygenation) has been proposed. The present study compared topical-ECMO with cold ischemia (CI) for lung preservation in an ex vivo experimental model.Design And SettingRandomized experimental study, conducted at a public medical school.MethodFourteen human lungs were retrieved from seven brain-dead donors that were considered unsuitable for transplantation. The lung bloc was divided and each lung was randomized to be preserved by means of topical-ECMO or CI (4-7 °C) for eight hours. These lungs were then reconnected to an ex vivo perfusion system for functional evaluation. Lung biopsies were obtained at three times. The functional variables assessed were oxygenation capacity (OC) and pulmonary artery pressure (PAP); and the histological variables were lung injury score (LIS) and apoptotic cell count (ACC).ResultsThe mean OC was 468 mmHg (± 81.6) in the topical-ECMO group and 455.8 (± 54) for CI (P = 0.758). The median PAP was 140 mmHg (120-160) in the topical-ECMO group and 140 mmHg (140-150) for CI (P = 0.285). The mean LIS was 35.57 (± 4.5) in the topical-ECMO group and 33.86 (± 6.1) for CI (P = 0.367). The ACC was 25.00 (± 9.34) in the topical-ECMO group and 24.86 (± 10.374) for CI (P = 0.803).ConclusionsThe present study showed that topical-ECMO was not superior to cold ischemia for up to eight hours of lung preservation.

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