Background: Static ice storage (SIS) has long been accepted as the conventional lung preservation method, assuming to maintain 4 °C temperature. Although never directly confirmed by temperature measurements, this assumption has been widely accepted. We aimed to measure lung and preservation temperature with SIS in porcine experiments and clinical observations. Methods: Porcine lungs were preserved with SIS for 8 h (group I, n = 3) and 3 h followed by 10 °C storage (group II, n = 3). Tissue (tissueT°), first bag preservation solution (psT°) and second bag saline (salineT°) temperature were monitored. In clinical lungs (n = 4), psT° was monitored during SIS. Surface (surfaceT°) and core (coreT°) temperature were assessed before and after SIS (n = 62). Results: After 4 h in porcine lung group I, average tissueT° was 0.66 °C, psT° was 0.12 °C and salineT° was −0.02 °C. After 3 h in group II, average tissueT° was 1.90 °C, psT° was 0.57 °C and salineT° was 2.33 °C. In clinical observations, psT° was below 4 °C after 9–13 min and 0 °C after 78–267 min. After SIS, median surfaceT° was 1.25 °C (min-max; −3.2–9.2 °C) and coreT° was 1.45 °C (−0.4–4.8 °C). Conclusions: SIS leads to rapid temperature drops below 4 °C, approaching 0 °C within 2–4 h. The post-SIS lung temperature shows considerable variability and does not consistently remain at the commonly assumed 4 °C, posing potential freezing injury to donor lungs.

Static ice storage (SIS) is the historic standard for lung preservation. It has been assumed that SIS results in 4°C organ temperatures. However, no prior studies measured lung temperature during SIS, potentially reaching near-freezing conditions. We aimed to measure lung and preservation temperature dynamics with SIS in porcine experiments and clinical observations. Methods: Porcine lungs were preserved with SIS for 8h (group I, n=3) and 3h followed by 10°C storage (group II, n=3). Tissue (tissueT°), 1st bag preservation solution (psT°) and 2nd bag saline (salineT°) temperature were monitored. In clinical lungs (n=4), psT° was monitored during SIS. Surface (surfaceT°) and core (coreT°) temperature were assessed before and after SIS (n=62). Results: After 4h in group I, average tissueT° was 0.66°C, psT° was 0.12°C, salineT° was -0.02°C. After 3h in group II, average tissueT° was 1.90°C, psT° was 0.57°C, salineT° was 2.33°C. In clinical observations, psT° was below 4°C after 9-13min and 0°C after 78-267min. After SIS, median surfaceT° was 1.25°C (min-max; -3.2°C – 9.2°C) , and coreT° was 1.45°C (-0.4°C – 4.8°C). Conclusions: SIS leads to rapid temperature drops below 4°C, approaching 0°C within 2-4 hours. Post-SIS lung temperature shows considerable variability and does not consistently remain at the commonly assumed 4°C, posing potential freezing injury to donor lungs.