Table 2.

Metabolomics in lung preservation for Tx.

Authors	Model	Metabolomics	Results
Animal studies
Pillai et al., 1986 [38]	NMP with oxygenated blood (4 h); Porcine DBD without Tx; N = n.d.	31P NMR spectroscopy, Metabolites from tissue	During NMP: ~ATP, ~phosphodiester, ~inorganic phosphate, ~phosphomonoester; During anoxia or ischemia: ↓ ATP, ↑ inorganic phosphate
Jayle et al., 2003 [39]	SCS in UW vs. EC vs. PEG (6 h) followed by 75 min NMP; Porcine DBD without Tx; N = 5/group	1H NMR spectroscopy; Metabolites from bronchoalveolar lavage	During NMP: ↑ lactate, ↑ pyruvate, ↑ citrate, ↑ acetate; SCS in UW vs. EC vs. PEG PEG: ~ lactate, ~citrate, ↓ acetate, ↓ pyruvate
Peltz et al., 2005 [40,41]	SCS in Perfadex® with 13C labeled glucose vs. pyruvate (6 and 24 h); Rats DBD without Tx; N = 4–6/group	13C NMR spectroscopy; Metabolites from tissue	SCS in Perfadex®with glucose vs. pyruvate Pyruvate: ↑ glutamate enrichment
Benahmed et al., 2012 [42]	HMP vs. SCS (3, 6 and 8 h); Porcine DCD without Tx; N = 8	1H NMR spectroscopy; 35 metabolites from tissue	SCS: ↑ majority of metabolites, ↓ glutathione, ↑ uracil; HMP: ~majority of metabolites, ~glutathione, ↓ uracil
Human studies
Hsin et al., 2018 [43]	NMP (1 h and 4 h); Marginal grafts with Tx; N = 50	Mass spectrometry; 275 metabolites from perfusate	PGD after 1 h of NMP: ↑ palmitoyl-sphingomyelin, ↑ 5-aminovalerate, ↑ decanoylcarnitine; PGD after 4 h of NMP: ↑ N2-methylguanosine, ↑ 5-aminovalerate, ↑ oleamide, ↑ decanoylcarnitine

DCD, donation after circulatory death; EC, Euro-Collins solution; HMP, hypothermic machine perfusion; NMP, normothermic machine perfusion; NMR, nuclear magnetic resonance; PGD, primary graft dysfunction; PEG, polyethylene glycol solution; SCS, static cold storage; Tx, transplantation.