ArticleRespiratory research2026
Comparative evaluation of PEGylated bovine hemoglobin as a perfusate in rat ex vivo lung perfusion.
Article in Respiratory research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
backgroundEx vivo lung perfusion (EVLP) is pivotal for assessing and preserving marginal donor lungs. While red-blood-cell (RBC)-based perfusates enhance oxygen delivery, they increase pulmonary vascular resistance, thereby potentially exacerbating perfusion-induced injury. This study compared a novel acellular oxygen carrier, PEGylated bovine hemoglobin (PEG-bHb), against RBC-based and acellular perfusates in a rat EVLP-transplantation model.
methodsA total of 49 rats were included in this study. Lungs underwent 4 h EVLP with acellular, RBC or PEG-bHb solutions, followed by left-lung transplantation and 2 h reperfusion; unperfused lungs served as controls. Respiratory mechanics, gas exchange, inflammatory cytokines, oxidative-stress markers, tight junction integrity (Occludin), and histology were evaluated. Bulk RNA-sequencing, qRT-PCR, and immunofluorescence for endoplasmic reticulum (ER) stress markers (ATF-6, ATF-4, CHOP and ubiquitin) were employed to explore underlying mechanisms.
resultsPEG-bHb demonstrated lower pulmonary vascular resistance and higher dynamic compliance than the RBC group. Inflammatory cytokine (IL-6, IL-1β, TNF-α) and Oxidative markers (MDA, HIF-1α) in lung tissue were reduced compared to acellular and RBC groups. Occludin expression indicated superior alveolar-capillary integrity versus control and acellular groups and parity with RBC group. Post-transplantation, the PEG-bHb group exhibited the least histological injury and the highest IL-10 expression, indicating attenuated early graft damage. Transcriptomic analysis suggested concurrent regulation of endoplasmic-reticulum stress and cytokine pathways; immunofluorescence demonstrated reduced ATF-6, increased ATF-4, and stable CHOP expression.
conclusionPEG-bHb reduced early post-transplant injury by preserving lung compliance, sustaining barrier integrity, and mitigating inflammatory stress during EVLP. It represents a promising candidate for clinical EVLP application.
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