A post-preservation vascular flush removes significant populations of donor leukocytes prior to lung transplantation

• Published in: Transplant immunology 2021-02, Vol.64, p.101356-101356, Article 101356
• Main Authors: Ball, Alexandra L., Edge, Rebecca J., Amin, Kavit, Critchley, William R., Howell, Gareth J., Yonan, Nizar, Stone, John P., Fildes, James E.
• Format: Article
• Language: English
• Subjects: Acute rejection; Allografts - immunology; Animals; Cell-Free Nucleic Acids - genetics; DNA, Mitochondrial - genetics; Immunity; Ischaemia-reperfusion injury; Leukocytes - immunology; Lung - immunology; Lung Transplantation; Models, Animal; Organ Preservation - methods; Passenger leukocytes; Preoperative Care; Preservation; Reperfusion Injury - prevention & control; Swine; T-Lymphocytes, Regulatory - immunology; Tissue Donors
• ISSN: 0966-3274; 1878-5492
• DOI: 10.1016/j.trim.2020.101356

Donor leukocytes are intrinsically involved in acute lung allograft rejection, via self-presentation of donor antigens to recipient leukocytes. Therapeutic modalities to remove donor leukocytes are currently unavailable. We evaluated if a vascular flush immediately following preservation can be used for this purpose. A post-preservation flush was performed with STEEN solution in n = 6 porcine lungs following static cold storage. The first 500 ml effluent from the left atrium was collected and an inflammatory profile performed. A total of 1.17 billion (±2.8 × 108) viable leukocytes were identified within the effluent. T cells were the dominant cell population, representing 82% of the total mobilised leukocytes, of which