β-Adrenergic agonist infusion during extracorporeal lung perfusion: Effects on glucose concentration in the perfusion fluid and on lung function

Valenza, Franco; Rosso, Lorenzo; Coppola, Silvia; Froio, Sara; Colombo, Jacopo; Dossi, Roberto Currò; Fumagalli, Jacopo; Salice, V.; Pizzocri, M.; Conte, G.; Gatti, Stefano; Santambrogio, Luigi; Gattinoni, Luciano

doi:10.1016/j.healun.2012.02.001

Cited by 31 publications

(24 citation statements)

References 43 publications

(24 reference statements)

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“…A remarkable outcome was a substantial extension of uninjured ex vivo perfusion to 180 min in the absence of pharmacological interventions. This successful achievement stems from our expertise in both clinical [12–14] and pre-clinical [15, 16] use of the isolated lung. The meticulous procedure description includes videos that show how critical steps were managed and solved.…”

Section: Discussionmentioning

confidence: 99%

Ex Vivo Lung Perfusion in the Rat: Detailed Procedure and Videos

et al. 2016

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Ex vivo lung perfusion (EVLP) is a promising procedure for evaluation, reconditioning, and treatment of marginal lungs before transplantation. Small animal models can contribute to improve clinical development of this technique and represent a substantial platform for bio-molecular investigations. However, to accomplish this purpose, EVLP models must sustain a prolonged reperfusion without pharmacological interventions. Currently available protocols only partly satisfy this need. The aim of the present research was accomplishment and optimization of a reproducible model for a protracted rat EVLP in the absence of anti-inflammatory treatment. A 180 min, uninjured and untreated perfusion was achieved through a stepwise implementation of the protocol. Flow rate, temperature, and tidal volume were gradually increased during the initial reperfusion phase to reduce hemodynamic and oxidative stress. Low flow rate combined with open atrium and protective ventilation strategy were applied to prevent lung damage. The videos enclosed show management of the most critical technical steps. The stability and reproducibility of the present procedure were confirmed by lung function evaluation and edema assessment. The meticulous description of the protocol provided in this paper can enable other laboratories to reproduce it effortlessly, supporting research in the EVLP field.

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Section: Discussionmentioning

confidence: 99%

Ex Vivo Lung Perfusion in the Rat: Detailed Procedure and Videos

et al. 2016

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“…Despite promising adjuvant therapies as salbutamol infusion/injection (28), adenosine A2A agonist (35), prostaglandin I 2 (37), NO (39,40), gene vector therapy (42,43), or neutrophil elastase inhibitor (46) being experimented in animal models, none of these have translated into standard clinical practice. The potential of EVLP as a research tool for novel therapies in lung transplantation is still to be further explored.…”

Section: Discussion and Future Directionsmentioning

confidence: 99%

“…In a randomized study, salbutamol or placebo was infused in a porcine model. Reduction in PAPs (16 vs. 21), improved oxygenation, and lung mechanics were found in the treatment group (28). Adenosine A2A agonist has been shown to decrease wet/dry ratios and inflammatory cytokines such as interferon-F, interleukin (IL)-1A, IL-6, and IL-8 when used during EVLP (35).…”

Section: Lung Metabolismmentioning

confidence: 97%

“…In a rat model, Fisher et al (28) demonstrated that low flow perfusion at 12 mL/g/min was superior to 25 mL/g/min in protecting from pulmonary edema. Sasaki et al (29), in their rabbit model, tested different perfusion pressures, concluding that 10 to 15 mmHg pressures were not associated with pulmonary edema, whereas less than 5 or more than 20 mmHg resulted in increased pulmonary edema and poor function of the lung.…”

Section: Perfusion-ventilation Protocolsmentioning

confidence: 99%

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Ex Vivo Lung Perfusion

Roman

Nair²,

Tsui³

et al. 2013

Transplantation

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There is a critical mismatch between the number of donor lungs available and the demand for lungs for transplantation. This has created unacceptably high waiting-list mortality for lung transplant recipients. Currently (2012) in the United Kingdom, there are 216 patients on the lung transplant waiting list and 17 on heart and lung transplant list. The waiting times for suitable lungs average 412 days, with an increasing mortality and morbidity among the patients on the lung transplant list. Ex vivo lung perfusion (EVLP) has emerged as a technique for the assessment, resuscitation, and potential repair of suboptimal donor lungs. This is a rapidly developing field with significant clinical implications. In this review article, we critically appraise the background developments that have led to our current clinical practice. In particular, we focus on the human and animal experience, the different perfusion-ventilation strategies, and the impact of different perfusates and leukocyte filters. Finally, we examine EVLP as a potential research tool. This will provide insight into EVLP and its future development in the field of clinical lung transplantation.

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“…Donor lung targeted injuries and their EVLP-specific treatments are summarized in Table 6. Gattinoni's group, using a pig EVLP model, described that the infusion of salbutamol (b-adrenergic receptor agonist) results in a decrease in mean PAP and an increase in lung dynamic compliance (p < 0.05) (58).…”

Section: Ongoing Clinical Trials Using Evlp Technologymentioning

confidence: 99%

Ex vivo lung perfusion

Reeb

Cypel

2016

Clinical Transplantation

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Lung transplantation is an established life-saving therapy for patients with end-stage lung disease. Unfortunately, greater success in lung transplantation is hindered by a shortage of lung donors and the relatively poor early-, mid-, and long-term outcomes associated with severe primary graft dysfunction. Ex vivo lung perfusion has emerged as a modern preservation technique that allows for a more accurate lung assessment and improvement in lung quality. This review outlines the: (i) rationale behind the method; (ii) techniques and protocols; (iii) Toronto ex vivo lung perfusion method; (iv) devices available; and (v) clinical experience worldwide. We also highlight the potential of ex vivo lung perfusion in leading a new era of lung preservation.

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β-Adrenergic agonist infusion during extracorporeal lung perfusion: Effects on glucose concentration in the perfusion fluid and on lung function

Cited by 31 publications

References 43 publications

Ex Vivo Lung Perfusion in the Rat: Detailed Procedure and Videos

Ex Vivo Lung Perfusion in the Rat: Detailed Procedure and Videos

Ex Vivo Lung Perfusion

Ex vivo lung perfusion

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