Procedure‐induced Inflammation and Endothelial Cell Activation in an Artificially Ventilated and Circulated Porcine Double‐Lung Model

Abstract

Systemic inflammation is induced during extracorporeal circulation, resulting in an increased bleeding tendency and endothelial cell activation. Lungs from seven piglets were perfused by autologous blood in an extracorporeal circuit, where the lungs and the left atrium were attached to polyvinyl chloride (PVC) tubings and the blood circulated by a roller pump. The trachea was intubated and attached to a ventilator. The lungs maintained good gas exchange, despite a slight increase in lactate levels. Plasma tPA increased slightly over time, suggesting endothelial cell activation. Activation of inflammatory systems was reflected in increased levels of plasma interleukin (IL)-6 and IL-10. A model for the study of lung endothelial activation during extracorporeal circulation has been shown to be reproducible. The lung tissue was shown to be capable of gas exchange and activation of endothelial cells and procedure-induced inflammation were noted.

Profiling inflammation and tissue injury markers in perfusate and bronchoalveolar lavage fluid during humanex vivolung perfusion

“…Increasing levels of inflammatory cytokines in perfusate and tissue have been shown during experimental lung perfusion in porcine models and a small preclinical human lung study, which might reflect procedure-mediated inflammation [27–29]. Our findings during full clinical EVLP support recent observations made by Machuca and colleagues [30] from Toronto and demonstrate the feasibility of identifying biomarkers that might improve EVLP assessment.…”

Post-transplant lymphoproliferative disease is associated with early sternotomy and left ventricular hypoplasia during infancy: a population-based retrospective review

“…Extracorporeal circulation activates the acute inflammatory response with raised serum levels of cytokines such as interleukin 6, 8, and 10. [12][13][14] An activated inflammatory response might theoretically increase the risk for lymphoma and in the present study the risk was significantly increased with the number of surgical events. In our cohort, three of 14 treated with extracorporeal membrane oxygenation developed post-transplant lymphoproliferative disorder; in spite of the fact that seven of the subjects had cardiomyopathies, none of them developed lymphoma.…”

Artificial Organs 2006: A Year in Review

“…Katrin Adrian et al. (52) of The Queen Silvia Children's Hospital (Göteborg, Sweden) reported on systemic inflammation induced during extracorporeal circulation that results in an increased bleeding tendency and endothelial cell (EC) activation. When lungs from seven piglets were perfused by autologous blood in an extracorporeal circuit, the lungs maintained good gas exchange, and plasma tPA increased over time suggesting EC activation.…”