Reconditioning of an injured lung graft with intrabronchial surfactant instillation in an ex vivo lung perfusion system followed by transplantation

İnci, İlhan; Hillinger, Sven; Arni, Stephan; Kaplan, Tevfik; Inci, Demet; Weder, Walter

doi:10.1016/j.jss.2013.04.043

Cited by 37 publications

(27 citation statements)

References 26 publications

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“…Our data demonstrated the feasibility of reconditioning and transplantation of an acutely damaged lung graft due to aspiration from a category-3 DCD donor (50).…”

Section: Proof Of Concept and Experimental Backgroundmentioning

confidence: 53%

“…In another study, we tested whether an injured lung graft from a category-3 DCD donor could be reconditioned with EVLP by intra-bronchial diluted surfactant lavage prior to transplantation (50). Our data demonstrated the feasibility of reconditioning and transplantation of an acutely damaged lung graft due to aspiration from a category-3 DCD donor (50).…”

Section: Proof Of Concept and Experimental Backgroundmentioning

confidence: 88%

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Donors after cardiocirculatory death and lung transplantation

İnci

2017

J. Thorac. Dis.

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Abstract:The number of patients actively awaiting lung transplantation (LTx) is more than the number of suitable donor lungs. The percentage of lung retrieval rate is lower when compared to other solid organs.The use of lungs from donation after cardiocirculatory death (DCD) donors is one of the options to avoid organ shortage in LTx. After extensive experimental research, clinical application of DCD donation is becoming wider. The results from most of the centers show at least equal survival rate compared to donors from brain death. This review paper will summarize experimental background and clinical experience from DCD donors.

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“…Our data demonstrated the feasibility of reconditioning and transplantation of an acutely damaged lung graft due to aspiration from a category-3 DCD donor (50).…”

Section: Proof Of Concept and Experimental Backgroundmentioning

confidence: 53%

Section: Proof Of Concept and Experimental Backgroundmentioning

confidence: 88%

Donors after cardiocirculatory death and lung transplantation

İnci

2017

J. Thorac. Dis.

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“…Inhaled nitric oxide and beta-adrenergic drugs were used in different studies. Another utilization of inhalation treatments is the one concerning surfactant (4,30). Anti-inflammatory drugs, antiapoptotic drugs, antibiotics, and immunosuppressants are added to the perfusate for treatment purposes.…”

Section: Examples For Study Methodsmentioning

confidence: 99%

Ex-vivo Lung Perfusion and Its Role in Experimental Studies

Cosgun¹,

Dabak²,

Şenbaklavacı³

2017

Eurasian J Pulmonol

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To date, lung transplantation is an accepted and a preferred treatment modality for end-stage lung diseases (1-3). But ischemia reperfusion--related injury, allograft rejection, bronchiolitis obliterans, and chronic graft rejection are still important and detrimental problems in lung transplant medicine (2). The gap between the limited number of donor organs and the increase in the number of patients on the waiting list is increasing rapidly. The acceptance of lung donors is still 20%-30% so far. The scarcity of appropriate organs leads to improper utilization of marginal donors. One of the solutions to increase the number of donor organs is the meticulous evaluation of donor organs after cardiac death (2-4). This is why a method called ex-vivo lung perfusion (EVLP) was developed. The usefulness of EVLP on lung transplantation is firstly because this model makes it possible to evaluate the lung perfusion and functions of the body in the pre transplant period in marginal organs. By this method, we can make the right decision to implant. Second area of utilization is by preserving the graft after harvesting over long time intervals. Third area provides a platform for the development of additional therapies especially decreasing ischemia reperfusion (IRI). In this review, we aimed to provide the usage of EVLP on the development of treatment strategies in experimental studies and share our experiences with colleagues in the related field (5). General Perspective of Organ Culture SystemsThe experimental sciences have routinely used in-vivo and in-vitro models for stimulation of physiology and diseases. As a result of integration of physics and chemistry into in-vitro and in-vivo biomedicine, study on cell cultures and analyzing them at the molecular level became possible. The aim of ex-vivo experimental studies of organs is to create a system to stimulate human pathophysiology. Sys- Review Ex-vivo Lung Perfusion and Its Role in Experimental StudiesTuğba Coşgun AbstractLung transplantation is an accepted treatment modality for end-stage lung diseases. However, the donor pool is not getting larger in comparison to the number of patients on the waiting list. Of the patients on the waiting list for lung transplant, more than a quarter dies while waiting. Utilization of marginal donors became an issue, and ex-vivo lung perfusion (EVLP) was started to be performed to solve this problem. Besides that, success in lung transplantation has not reached a satisfactory level for various reasons including ischemia reperfusion injury. Treatment options against these reasons that cause low success of lung transplantations are being investigated by many centers. Nowadays, EVLP that was initially developed to re-evaluate marginal donors has become a method for studies in experimental models. In our article, we want to review EVLP models in experimental studies.

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“…Already, strategies using existing therapies such as thrombolytic treatment for lungs affected by pulmonary emboli have been successfully employed [27,28]. Employment of other drugs during EVLP such as antibiotics for lungs rejected due to pneumonia, surfactant for lungs injured by aspiration, and terbutaline for edematous lungs remains under study [29][30][31]. One major advantage of therapy during EVLP is that the lungs are isolated from other organs, and thus medication doses otherwise harmful to other organs can be utilized.…”

Section: Future Directionsmentioning

confidence: 99%