Effect of the systemic administration of methylprednisolone on the lungs of brain-dead donor rats undergoing pulmonary transplantation

Abstract

OBJECTIVE:Most lung transplants are obtained from brain-dead donors. The physiopathology of brain death involves hemodynamics, the sympathetic nervous system, and inflammatory mechanisms. Administering methylprednisolone 60 min after inducing brain death in rats has been shown to modulate pulmonary inflammatory activity. Our objective was to evaluate the effects of methylprednisolone on transplanted rat lungs from donors treated 60 min after brain death.METHODS:Twelve Wistar rats were anesthetized, and brain death was induced. They were randomly divided into two groups (n = 6), namely a control group, which was administered saline solution, and a methylprednisolone group, which received the drug 60 min after the induction of brain death. All of the animals were observed and ventilated for 2 h prior to being submitted to lung transplantation. We evaluated the hemodynamic and blood gas parameters, histological score, lung tissue levels of thiobarbituric acid-reactive substances, level of superoxide dismutase, level of tumor necrosis factor-alpha, and level of interleukin-1 beta.RESULTS:After transplantation, a significant reduction in the levels of tumor necrosis factor-alpha and IL-1β was observed in the group that received methylprednisolone (p = 0.0084 and p = 0.0155, respectively). There were no significant differences in tumor necrosis factor-alpha and superoxide dismutase levels between the control and methylprednisolone groups (p = 0.2644 and p = 0.7461, respectively). There were no significant differences in the blood gas parameters, hemodynamics, and histological alterations between the groups.CONCLUSION:The administration of methylprednisolone after brain death in donor rats reduces inflammatory activity in transplanted lungs but has no influence on parameters related to oxidative stress.

Mechanical versus humoral determinants of brain death-induced lung injury

“…It could be partially explained by the absence of effects of methylprednisolone pretreatment on the oxidative stress markers. The administration of methylprednisolone 60-min after brain death in donor rats has been shown to reduce inflammatory activity in transplanted lungs, but has no influence on parameters related to oxidative stress [ 64 ]. Methylprednisolone has been, reported to limit endothelial cell damage [ 65 ] and therefore to prevent increased lung vascular permeability in experimental endotoxemia [ 66 ].…”

Avaliação funcional e inflamatória de pulmões submetidos ao tratamento com solução salina hipertônica em modelo de morte encefálica

“…O transplante de pulmão ganhou notoriedade após grandes avanços na área da terapia intensiva, imunologia e farmacologia 3,4 . Um expressivo aumento no número de centros transplantadores ao redor do mundo, com resultados efetivos, desencadeou um relevante crescimento de pacientes em listas de espera, uma consequência já esperada, devido ao aumento da credibilidade na técnica 5 . Segundo The International Society of Heart & Lung Transplantation (ISHLT), houve uma evolução no número de transplantes realizados, o procedimento passou de cerca de 2000 casos em 2005, para pouco mais de 4000 casos em 2015 6,7 .…”