BACKGROUND: We have previously shown that an initial 10-minute period of low-pressure reperfusion prevents the lung graft dysfunction that follows physiologic-pressure reperfusion. Possible mechanisms were investigated in this study. METHODS: Rat lungs were reperfused ex vivo using a parabiotic animal after 0-hour (groups A through C) or 24-hour (groups D through G) storage. Reperfusion pressure was either physiologic (groups A through D) or reduced by 50% for a specified time (groups E through G). The duration of reperfusion was 5 minutes (groups A, D, and E), 10 minutes (groups B and F), or 30 minutes (groups C and G), at which time endothelial permeability was measured through iodine 125-labeled albumin leakage and neutrophil sequestration through tissue myeloperoxidase activity. RESULTS: Graft function in group D deteriorated rapidly, whereas groups E through G performed at control levels. Albumin leakage was significantly elevated in group D; with controlled reperfusion, it was elevated after 5 minutes (group E) but had returned to baseline at 10 minutes (group F) and 30 minutes (group G). Myeloperoxidase levels were not significantly different between groups. CONCLUSIONS: Endothelial permeability is transiently elevated in the early phase of lung graft reperfusion. Initial low-pressure reperfusion may be protective by preventing irreversible edema formation during this period.
BACKGROUND: We have previously shown that an initial 10-minute period of low-pressure reperfusion prevents the lung graft dysfunction that follows physiologic-pressure reperfusion. Possible mechanisms were investigated in this study. METHODS:Rat lungs were reperfused ex vivo using a parabiotic animal after 0-hour (groups A through C) or 24-hour (groups D through G) storage. Reperfusion pressure was either physiologic (groups A through D) or reduced by 50% for a specified time (groups E through G). The duration of reperfusion was 5 minutes (groups A, D, and E), 10 minutes (groups B and F), or 30 minutes (groups C and G), at which time endothelial permeability was measured through iodine 125-labeled albumin leakage and neutrophil sequestration through tissue myeloperoxidase activity. RESULTS: Graft function in group D deteriorated rapidly, whereas groups E through G performed at control levels. Albumin leakage was significantly elevated in group D; with controlled reperfusion, it was elevated after 5 minutes (group E) but had returned to baseline at 10 minutes (group F) and 30 minutes (group G). Myeloperoxidase levels were not significantly different between groups. CONCLUSIONS: Endothelial permeability is transiently elevated in the early phase of lung graft reperfusion. Initial low-pressure reperfusion may be protective by preventing irreversible edema formation during this period.
Authors: Monica Casiraghi; Jason R Tatreau; John B Abano; John W Blackwell; Larry Watson; Keith Burridge; Scott H Randell; Thomas M Egan Journal: J Thorac Cardiovasc Surg Date: 2009-09 Impact factor: 5.209
Authors: Bernhard Moser; Peter Jaksch; Shahrokh Taghavi; Gabriella Muraközy; Georg Lang; Helmut Hager; Claus Krenn; Georg Roth; Peter Faybik; Andreas Bacher; Clemens Aigner; José R Matilla; Konrad Hoetzenecker; Philipp Hacker; Irene Lang; Walter Klepetko Journal: Eur J Cardiothorac Surg Date: 2018-01-01 Impact factor: 4.191