Prevention of ischemia-reperfusion lung injury during static cold preservation by supplementation of standard preservation solution with HEMO 2 life ® in pig lung transplantation model

Artif Cells Nanomed Biotechnol. 2018 Dec;46(8):1773-1780. doi: 10.1080/21691401.2017.1392315. Epub 2017 Oct 25.


We describe the results of adding a new biological agent HEMO2life® to a standard preservation solution for hypothermic static lung preservation aiming to improve early functional parameters after lung transplantation. HEMO2life® is a natural oxygen carrier extracted from Arenicola marina with high oxygen affinity developed as an additive to standard organ preservation solutions. Standard preservation solution (Perfadex®) was compared with Perfadex® associated with HEMO2life® and with sham animals after 24 h of hypothermic preservation followed by lung transplantation. During five hours of lung reperfusion, functional parameters and biomarkers expression in serum and in bronchoalveolar lavage fluid (BALF) were measured. After five hours of reperfusion, HEMO2life® group led to significant improvement in functional parameters: reduction of graft vascular resistance (p < .05) and increase in graft oxygenation ratio (p < .05). Several ischemia-reperfusion related biomarkers showed positive trends in the HEMO2life® group: expression of HMG B1 in serum tended to be lower in comparison (2.1 ± 0.8 vs. 4.6 ± 1.5) with Perfadex® group, TNF-α and IL-8 in BALF were significantly higher in the two experimental groups compared to control (p < .05). During cold ischemia, expression of HIF1α and histology remained unchanged and similar to control. Supplementation of the Perfadex® solution by an innovative oxygen carrier HEMO2life® during hypothermic static preservation improves early graft function after prolonged cold ischemia in lung transplantation.

Keywords: Graft preservation; HEMO2life®; HMG B1; alarmin; ischemia reperfusion injury; lung transplantation; oxygen carrier; primary graft dysfunction.

MeSH terms

  • Animals
  • Blood Substitutes / pharmacology*
  • Disease Models, Animal
  • Lung Transplantation*
  • Lung*
  • Organ Preservation / methods*
  • Organ Preservation Solutions / pharmacology*
  • Reperfusion Injury / metabolism
  • Reperfusion Injury / pathology
  • Reperfusion Injury / prevention & control*
  • Swine


  • Blood Substitutes
  • Organ Preservation Solutions