Subnormothermic ex vivo lung perfusion attenuates ischemia reperfusion injury from donation after circulatory death donors.

Use of normothermic ex vivo lung perfusion (EVLP) was adopted in clinical practice to assess the quality of marginal donor lungs. Subnormothermic perfusion temperatures are in use among other solid organs to improve biochemical, clinical and immunological parameters. In a rat EVLP model of donation...

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Autores principales:	Stephan Arni, Tatsuo Maeyashiki, Isabelle Opitz, Ilhan Inci
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/0a989b70fad5485484d84a8bd0d72c92
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spelling	oai:doaj.org-article:0a989b70fad5485484d84a8bd0d72c922021-12-02T20:18:52ZSubnormothermic ex vivo lung perfusion attenuates ischemia reperfusion injury from donation after circulatory death donors.1932-620310.1371/journal.pone.0255155https://doaj.org/article/0a989b70fad5485484d84a8bd0d72c922021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255155https://doaj.org/toc/1932-6203Use of normothermic ex vivo lung perfusion (EVLP) was adopted in clinical practice to assess the quality of marginal donor lungs. Subnormothermic perfusion temperatures are in use among other solid organs to improve biochemical, clinical and immunological parameters. In a rat EVLP model of donation after circulatory death (DCD) lung donors, we tested the effect of four subnormothermic EVLP temperatures that could further improve organ preservation. Warm ischemic time was of 2 hours. EVLP time was of 4 hours. Lung physiological data were recorded and metabolic parameters were assessed. Lung oxygenation at 21°C and 24°C were significantly improved whereas pulmonary vascular resistance and edema formation at 21°C EVLP were significantly worsened when compared to 37°C EVLP. The perfusate concentrations of potassium ions and lactate exiting the lungs with 28°C EVLP were significantly lower whereas sodium and chlorine ions with 32°C EVLP were significantly higher when compared to 37°C EVLP. Also compared to 37°C EVLP, the pro-inflammatory chemokines MIP2, MIP-1α, GRO-α, the cytokine IL-6 were significantly lower with 21°C, 24°C and 28°C EVLP, the IL-18 was significantly lower but only with 21°C EVLP and IL-1β was significantly lower at 21°C and 24°C EVLP. Compared to the 37°C EVLP, the lung tissue ATP content after 21°C, 24°C and 28°C EVLP were significantly higher, the carbonylated protein content after 28°C EVLP was significantly lower and we measured significantly higher myeloperoxidase activities in lung tissues with 21°C, 24°C and 32°C. The 28°C EVLP demonstrated acceptable physiological variables, significantly higher lung tissue ATP content and decreased tissue carbonylated proteins with reduced release of pro-inflammatory cytokines. In conclusion, the 28°C EVLP is a non inferior setting in comparison to the clinically approved 37°C EVLP and significantly improve biochemical, clinical and immunological parameters and may reduce I/R injuries of DCD lung donors.Stephan ArniTatsuo MaeyashikiIsabelle OpitzIlhan InciPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0255155 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Stephan Arni Tatsuo Maeyashiki Isabelle Opitz Ilhan Inci Subnormothermic ex vivo lung perfusion attenuates ischemia reperfusion injury from donation after circulatory death donors.
description	Use of normothermic ex vivo lung perfusion (EVLP) was adopted in clinical practice to assess the quality of marginal donor lungs. Subnormothermic perfusion temperatures are in use among other solid organs to improve biochemical, clinical and immunological parameters. In a rat EVLP model of donation after circulatory death (DCD) lung donors, we tested the effect of four subnormothermic EVLP temperatures that could further improve organ preservation. Warm ischemic time was of 2 hours. EVLP time was of 4 hours. Lung physiological data were recorded and metabolic parameters were assessed. Lung oxygenation at 21°C and 24°C were significantly improved whereas pulmonary vascular resistance and edema formation at 21°C EVLP were significantly worsened when compared to 37°C EVLP. The perfusate concentrations of potassium ions and lactate exiting the lungs with 28°C EVLP were significantly lower whereas sodium and chlorine ions with 32°C EVLP were significantly higher when compared to 37°C EVLP. Also compared to 37°C EVLP, the pro-inflammatory chemokines MIP2, MIP-1α, GRO-α, the cytokine IL-6 were significantly lower with 21°C, 24°C and 28°C EVLP, the IL-18 was significantly lower but only with 21°C EVLP and IL-1β was significantly lower at 21°C and 24°C EVLP. Compared to the 37°C EVLP, the lung tissue ATP content after 21°C, 24°C and 28°C EVLP were significantly higher, the carbonylated protein content after 28°C EVLP was significantly lower and we measured significantly higher myeloperoxidase activities in lung tissues with 21°C, 24°C and 32°C. The 28°C EVLP demonstrated acceptable physiological variables, significantly higher lung tissue ATP content and decreased tissue carbonylated proteins with reduced release of pro-inflammatory cytokines. In conclusion, the 28°C EVLP is a non inferior setting in comparison to the clinically approved 37°C EVLP and significantly improve biochemical, clinical and immunological parameters and may reduce I/R injuries of DCD lung donors.
format	article
author	Stephan Arni Tatsuo Maeyashiki Isabelle Opitz Ilhan Inci
author_facet	Stephan Arni Tatsuo Maeyashiki Isabelle Opitz Ilhan Inci
author_sort	Stephan Arni
title	Subnormothermic ex vivo lung perfusion attenuates ischemia reperfusion injury from donation after circulatory death donors.
title_short	Subnormothermic ex vivo lung perfusion attenuates ischemia reperfusion injury from donation after circulatory death donors.
title_full	Subnormothermic ex vivo lung perfusion attenuates ischemia reperfusion injury from donation after circulatory death donors.
title_fullStr	Subnormothermic ex vivo lung perfusion attenuates ischemia reperfusion injury from donation after circulatory death donors.
title_full_unstemmed	Subnormothermic ex vivo lung perfusion attenuates ischemia reperfusion injury from donation after circulatory death donors.
title_sort	subnormothermic ex vivo lung perfusion attenuates ischemia reperfusion injury from donation after circulatory death donors.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/0a989b70fad5485484d84a8bd0d72c92
work_keys_str_mv	AT stephanarni subnormothermicexvivolungperfusionattenuatesischemiareperfusioninjuryfromdonationaftercirculatorydeathdonors AT tatsuomaeyashiki subnormothermicexvivolungperfusionattenuatesischemiareperfusioninjuryfromdonationaftercirculatorydeathdonors AT isabelleopitz subnormothermicexvivolungperfusionattenuatesischemiareperfusioninjuryfromdonationaftercirculatorydeathdonors AT ilhaninci subnormothermicexvivolungperfusionattenuatesischemiareperfusioninjuryfromdonationaftercirculatorydeathdonors
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Subnormothermic ex vivo lung perfusion attenuates ischemia reperfusion injury from donation after circulatory death donors.

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