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J Thorac Cardiovasc Surg 2009;137:492-498
© 2009 The American Association for Thoracic Surgery

Evolving Technology

Cellular electrophysiologic and mechanical evidence of superior vascular protection in pulmonary microcirculation by Perfadex compared with Celsior

^a Department of Surgery, The Chinese University of Hong Kong, Hong Kong
^b Guangdong Provincial People's Hospital, Guangzhou, China
^c Medical College, Nankai University and TEDA International Cardiovascular Hospital, Tianjin, China
^d Providence Heart and Vascular Institute, Albert Starr Academic Center, Department of Surgery, Oregon Health and Science University, Portland, Oregon

Received for publication December 28, 2007; revisions received May 29, 2008; accepted for publication August 28, 2008.

^_* Address for reprints: Guo-Wei He, MD, PhD, DSc, Department of Surgery, The Chinese University of Hong Kong, 5A, Block B, Prince of Wales Hospital, Shatin, N.T., Hong Kong SAR, China. (Email: gwhe{at}cuhk.edu.hk).

Objective: Pulmonary endothelial function is critical in posttransplant lung performance. Hyperkalemic organ preservation solutions alter vascular endothelial function through the non-nitric oxide and non-prostacyclin pathway, but the most frequently used lung preservation solutions, Perfadex (Vitrolife Sweden, Kungsbacka, Sweden) (K⁺ 6 mmol/L) and Celsior (IMTIX SangStat Company, Lyon, France) (K⁺ 15 mmol/L), have not been evaluated on pulmonary endothelial protection. We compared the non-nitric oxide and non-prostacyclin–mediated endothelial function in porcine pulmonary microarteries of lung preserved by Perfadex or Celsior solution at 4°C for 4 hours.

Methods: The non-nitric oxide and non-prostacyclin–mediated endothelial function was determined by measuring the membrane potential in a single pulmonary smooth muscle cell (group II, n = 6) and bradykinin-induced relaxation (group I, n = 8) in pulmonary microarteries preserved in Krebs (a, control), Perfadex (b), or Celsior (c), with inhibitors of nitric oxide and prostacyclin.

Results: Membrane potential hyperpolarization decreased in IIc (4.5 ± 0.2 mV, P < .05) but was preserved (P > .05) in IIa (6.6 ± 0.1 mV) and IIb (6.3 ± 0.3 mV). Resting membrane potential was depolarized in IIc (–42.8 ± 1.3 mV) compared with IIa (–58.7 ± 0.6 mV) and IIb (–56.7 ± 0.9 mV) (P < .05). Hyperpolarization-associated relaxation (37.3% ± 7.2% vs 59.7% ± 7.7%) and sensitivity (EC₅₀) (–7.29 ± 0.13 vs –7.75 ± 0.06 log M) to bradykinin significantly (P < .05) decreased in Ic but not in Ia and Ib.

Conclusion: This in vitro study simulating clinical conditions demonstrates that Perfadex preserves endothelium-dependent smooth muscle relaxation and hyperpolarization better than Celsior solution in regard to the electrophysiologic and mechanical properties observed at cellular and vascular levels. This study provides a new method at the level of basic science to evaluate the solutions for heart/lung preservation.