Little is known regarding the influence of different preservation techniques (i.e. cold static storage with Perfadex® or Celsior® solution) on the immunological milieu, especially lung-resident lymphocyte subsets and the cytokine/chemokine milieu in lung transplantation (LTx). NK and T cells, depending on their cell surface receptor repertoire and their cytolytic function, can have pro- and anti-inflammatory effects and, hence, can promote a tolerogenic or immunogenic environment. We aimed to identify how the preservation technique may alter the immunological milieu. Therefore, we investigated the pulmonary and peripheral lymphocyte repertoire and assessed the in vitro migratory capacity of lymphocyte subsets depending on the different perfusion solutions in clinical LTx.

Lymphocytes from peripheral blood (PBMC) and perfusion solution from 42 LTx, Perfadex (n=19) and Celsior (n=23), were isolated by Ficoll. T and NK cell subsets were analyzed by FACS. Cell migration assays were performed with perfusion solutions, incubated with PBMC and quantified by FACS.

The pulmonary compartment is associated with significant changes in lymphocyte composition and surface receptor expression compared to PBMC. Lymphocytes in Celsior solutions contained significantly more CD8+ T cells (p<0,023) and less CD4+ T cells which translates to an altered CD4/CD8 ratio (p<0.045), discriminating it from Perfadex. These findings correlate directly post-op with an increased CD8+ and reversely, decreased CD4+ T cell repertoire of Celsior recipient (p<0,009). Post-op T cell subsets also differed significantly between these perfusion solutions (p<0,023). Remarkably, Celsior solution shows also in vitro an increased migratory effect on T cells compared to medium and Perfadex solutions (p<0,003).

The significant differences between pulmonary and peripheral lymphocytes indicate that the choice of the perfusion solution may have an impact on the immunological milieu through distinct cell migratory capacities, recruiting specific lymphocytes subsets. This effect could alter the pulmonary immunological environment and may influence the tolerance-rejection balance.

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