Lung preservation

Perrot, Marc de; Keshavjee, Shaf

doi:10.1053/j.semtcvs.2004.09.012

Cited by 56 publications

(10 citation statements)

References 59 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similar to other investigations, we have then used a single lung transplantation procedure [ 39 , 40 ]. Lung function early after reperfusion has been carefully monitored, as reperfusion injury is generally considered an outcome measure in lung preservation studies [ 41 ]. For this reason, based on the known effects of perfusion and ventilation on ischemia-reperfusion lung injury [ 42 , 43 ], meticulous attention was given to the reperfusion protocol.…”

Section: Discussionmentioning

confidence: 99%

A standardized model of brain death, donor treatment, and lung transplantation for studies on organ preservation and reconditioning

Valenza

Coppola

Froio

et al. 2014

ICMx

View full text Add to dashboard Cite

BackgroundWe set a model of brain death, donor management, and lung transplantation for studies on lung preservation and reconditioning before transplantation.MethodsTen pigs (39.7 ± 5.9 Kg) were investigated. Five animals underwent brain death and were treated as organ donors; the lungs were then procured and cold stored (Ischemia). Five recipients underwent left lung transplantation and post-reperfusion follow-up (Graft). Cardiorespiratory and metabolic parameters were collected. Lung gene expression of cytokines (tumor necrosis factor alpha (TNFα), interleukin-1 beta (IL-1β), interleukin-6 (IL-6), interferon gamma (IFNγ), high mobility group box-1 (HMGB-1)), chemokines (chemokine CC motif ligand-2 (CCL2-MCP-1), chemokine CXC motif ligand-10 (CXCL-10), interleukin-8 (IL-8)), and endothelial activation markers (endothelin-1 (EDN-1), intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), selectin-E (SELE)) was assessed by real-time polymerase chain reaction (PCR).ResultsTachycardia and hypertension occurred during brain death induction; cardiac output rose, systemic vascular resistance dropped (P < 0.05), and diabetes insipidus occurred. Lung-protective ventilation strategy was applied: 9 h after brain death induction, PaO2 was 192 ± 12 mmHg at positive end-expiratory pressure (PEEP) 8.0 ± 1.8 cmH2O and FiO2 of 40%; wet-to-dry ratio (W/D) was 5.8 ± 0.5, and extravascular lung water (EVLW) was 359 ± 80 mL. Procured lungs were cold-stored for 471 ± 24 min (Ischemia) at the end of which W/D was 6.1 ± 0.9. Left lungs were transplanted and reperfused (warm ischemia 98 ± 14 min). Six hours after controlled reperfusion, PaO2 was 192 ± 23 mmHg (PEEP 8.7 ± 1.5 cmH2O, FiO2 40%), W/D was 5.6 ± 0.4, and EVLW was 366 ± 117 mL. Levels of IL-8 rose at the end of donor management (BD, P < 0.05); CCL2-MCP-1, IL-8, HMGB-1, and SELE were significantly altered after reperfusion (Graft, P < 0.05).ConclusionsWe have set a standardized, reproducible pig model resembling the entire process of organ donation that may be used as a platform to test in vivo and ex vivo strategies of donor lung optimization before transplantation.Electronic supplementary materialThe online version of this article (doi:10.1186/2197-425X-2-12) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionmentioning

confidence: 99%

A standardized model of brain death, donor treatment, and lung transplantation for studies on organ preservation and reconditioning

Valenza

Coppola

Froio

et al. 2014

ICMx

View full text Add to dashboard Cite

show abstract

“…8,40,41,114,115 Several therapeutic agents have been investigated in an effort to reduce the incidence of PGD, including 5 (1) agents replacing endogenous cytoprotective substances including prostaglandins, nitric oxide (NO), surfactant, endotheliumderived relaxing factor, and adenosine; (2) agents inhibiting proinflammatory mediators including platelet activating factor 1 inhibitor and inhibitors of ROS; and (3) agents inhibiting neutrophil and neutrophil-derived mediators including inhibitors of ROS, cytokines (TNF-α, IL-1β), proteases, lipid mediators, adhesion molecules, and complement cascade. 5,8,114,116 However, there have been only a few randomized trials, usually with limited sample sizes. 5 These small trials have failed to definitively demonstrate efficacy and remain an area of intense study, 98,[117][118][119][120][121][122] even though some studies have shown modest improvements in early clinical outcomes with use of inhaled NO (iNO), 98 surfactant, 122 soluble complement receptor 1 inhibitor, 119 and platelet-activating factor antagonist.…”

Section: Preventive Interventionsmentioning

confidence: 99%

Primary Graft Dysfunction

Suzuki

Cantu

Christie

2013

Semin Respir Crit Care Med

118

View full text Add to dashboard Cite

Primary graft dysfunction (PGD) is a syndrome encompassing a spectrum of mild to severe lung injury that occurs within the first 72 hours after lung transplantation. PGD is characterized by pulmonary edema with diffuse alveolar damage that manifests clinically as progressive hypoxemia with radiographic pulmonary infiltrates. In recent years, new knowledge has been generated on risks and mechanisms of PGD. Following ischemia and reperfusion, inflammatory and immunological injury-repair responses appear to be key controlling mechanisms. In addition, PGD has significant impact on short- and long-term outcomes; therefore, the choice of donor organ is impacted by this potential adverse consequence. Improved methods of reducing PGD risk and efforts to safely expand the pool are being developed. Ex-vivo lung perfusion is a strategy which may improve risk assessment and become a promising platform to implement treatment interventions to prevent PGD. This review will detail recent updates in the epidemiology, pathophysiology, molecular and genetic biomarkers and state-of-the-art technical developments affecting PGD. (158 words)

show abstract

“…The preservation of donor lungs during the cold ischemia phase (CIP) is crucial for prognosis after lung transplantation (LTx). The conventional preservation methods for donor lungs include lung preservation solution and perfusion solution, hypothermic preservation (4–8°C), and lung inflation with oxygen or air ( de Perrot and Keshavjee, 2004 ). However, these methods are not sufficient for lung preservation.…”

Section: Introductionmentioning

confidence: 99%

Lung Inflation With Hydrogen During the Cold Ischemia Phase Alleviates Lung Ischemia-Reperfusion Injury by Inhibiting Pyroptosis in Rats

et al. 2021

View full text Add to dashboard Cite

Background: Lung inflation with hydrogen is an effective method to protect donor lungs from lung ischemia-reperfusion injury (IRI). This study aimed to examine the effect of lung inflation with 3% hydrogen during the cold ischemia phase on pyroptosis in lung grafts of rats.Methods: Adult male Wistar rats were randomly divided into the sham group, the control group, the oxygen (O2) group, and the hydrogen (H2) group. The sham group underwent thoracotomy but no lung transplantation. In the control group, the donor lungs were deflated for 2 h. In the O2 and H2 groups, the donor lungs were inflated with 40% O2 + 60% N2 and 3% H2 + 40% O2 + 57% N2, respectively, at 10 ml/kg, and the gas was replaced every 20 min during the cold ischemia phase for 2 h. Two hours after orthotopic lung transplantation, the recipients were euthanized.Results: Compared with the control group, the O2 and H2 groups improved oxygenation indices, decreases the inflammatory response and oxidative stress, reduced lung injury, and improved pressure-volume (P-V) curves. H2 had a better protective effect than O2. Furthermore, the levels of the pyroptosis-related proteins selective nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3), cysteinyl aspartate specific proteinase (caspase)-1 p20, and the N-terminal of gasdermin D (GSDMD-N) were decreased in the H2 group.Conclusion: Lung inflation with 3% hydrogen during the cold ischemia phase inhibited the inflammatory response, oxidative stress, and pyroptosis and improved the function of the graft. Inhibiting reactive oxygen species (ROS) production may be the main mechanism of the antipyroptotic effect of hydrogen.

show abstract

Lung preservation

Cited by 56 publications

References 59 publications

A standardized model of brain death, donor treatment, and lung transplantation for studies on organ preservation and reconditioning

A standardized model of brain death, donor treatment, and lung transplantation for studies on organ preservation and reconditioning

Primary Graft Dysfunction

Lung Inflation With Hydrogen During the Cold Ischemia Phase Alleviates Lung Ischemia-Reperfusion Injury by Inhibiting Pyroptosis in Rats

Contact Info

Product

Resources

About