Anna Elisabeth Frick1, Michaela Orlitová2, Arno Vanstapel3, Sofie Ordies2, Sandra Claes4, Dominique Schols4, Tobias Heigl3, Janne Kaes3, Berta Saez-Gimenez3,5, Robin Vos3,6, Geert M Verleden3,6, Bart Vanaudenaerde3, Stijn E Verleden3, Dirk E Van Raemdonck3,7, Arne P Neyrinck2,8. 1. Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium. annaelisabeth.frick@ymail.com. 2. Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium. 3. BREATHE, Department of Chronic Diseases, Metabolism and Ageing (Chrometa), Leuven Lung Transplant Unit, KU Leuven, Leuven, Belgium. 4. Laboratory of Virology and Chemotherapy, Department of Microbiology and Immunology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium. 5. Lung Transplant Unit, Hospital Universitari Vall D'Hebron, Barcelona, Spain. 6. Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium. 7. Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium. 8. Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium.
Abstract
BACKGROUND: Primary graft dysfunction (PGD) remains a major obstacle after lung transplantation. Ischemia-reperfusion injury is a known contributor to the development of PGD following lung transplantation. We developed a novel approach to assess the impact of increased pulmonary blood flow in a large porcine single-left lung transplantation model. MATERIALS: Twelve porcine left lung transplants were divided in two groups (n = 6, in low- (LF) and high-flow (HF) group). Donor lungs were stored for 24 h on ice, followed by left lung transplantation. In the HF group, recipient animals were observed for 6 h after reperfusion with partially clamping right pulmonary artery to achieve a higher flow (target flow 40-60% of total cardiac output) to the transplanted lung compared to the LF group, where the right pulmonary artery was not clamped. RESULTS: Survival at 6 h was 100% in both groups. Histological, functional and biological assessment did not significantly differ between both groups during the first 6 h of reperfusion. injury was also present in the right native lung and showed signs compatible with the pathophysiological hallmarks of ischemia-reperfusion injury. CONCLUSIONS: Partial clamping native pulmonary artery in large animal lung transplantation setting to study the impact of low versus high pulmonary flow on the development of ischemia reperfusion is feasible. In our study, differential blood flow had no effect on IRI. However, our findings might impact future studies with extracorporeal devices and represent a specific intra-operative problem during bilateral sequential single-lung transplantation.
BACKGROUND:Primary graft dysfunction (PGD) remains a major obstacle after lung transplantation. Ischemia-reperfusion injury is a known contributor to the development of PGD following lung transplantation. We developed a novel approach to assess the impact of increased pulmonary blood flow in a large porcine single-left lung transplantation model. MATERIALS: Twelve porcine left lung transplants were divided in two groups (n = 6, in low- (LF) and high-flow (HF) group). Donor lungs were stored for 24 h on ice, followed by left lung transplantation. In the HF group, recipient animals were observed for 6 h after reperfusion with partially clamping right pulmonary artery to achieve a higher flow (target flow 40-60% of total cardiac output) to the transplanted lung compared to the LF group, where the right pulmonary artery was not clamped. RESULTS: Survival at 6 h was 100% in both groups. Histological, functional and biological assessment did not significantly differ between both groups during the first 6 h of reperfusion. injury was also present in the right native lung and showed signs compatible with the pathophysiological hallmarks of ischemia-reperfusion injury. CONCLUSIONS:Partial clamping native pulmonary artery in large animal lung transplantation setting to study the impact of low versus high pulmonary flow on the development of ischemia reperfusion is feasible. In our study, differential blood flow had no effect on IRI. However, our findings might impact future studies with extracorporeal devices and represent a specific intra-operative problem during bilateral sequential single-lung transplantation.
Authors: Alberto Benazzo; Stefan Schwarz; Florian Frommlet; Thomas Schweiger; Peter Jaksch; Peter Schellongowski; Thomas Staudinger; Walter Klepetko; György Lang; Konrad Hoetzenecker Journal: J Thorac Cardiovasc Surg Date: 2019-02-27 Impact factor: 5.209
Authors: Iran A N Silva; Nika Gvazava; Deniz A Bölükbas; Martin Stenlo; Jiao Dong; Snejana Hyllen; Leif Pierre; Sandra Lindstedt; Darcy E Wagner Journal: Bio Protoc Date: 2022-08-20