A novel experimental porcine model to assess the impact of differential pulmonary blood flow on ischemia–reperfusion injury after unilateral lung transplantation

Intensive Care Medicine Experimental

Arno Vanstapel¹  Stijn E. Verleden¹  Janne Kaes¹  Tobias Heigl¹  Bart Vanaudenaerde¹  Robin Vos²  Geert M. Verleden²  Dirk E. Van Raemdonck³  Berta Saez-Gimenez⁴  Sofie Ordies⁵  Michaela Orlitová⁵  Anna Elisabeth Frick⁵  Arne P. Neyrinck⁶  Sandra Claes⁷  Dominique Schols⁷ 

[1] BREATHE, Department of Chronic Diseases, Metabolism and Ageing (Chrometa), Leuven Lung Transplant Unit, KU Leuven, Leuven, Belgium;BREATHE, Department of Chronic Diseases, Metabolism and Ageing (Chrometa), Leuven Lung Transplant Unit, KU Leuven, Leuven, Belgium;Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium;BREATHE, Department of Chronic Diseases, Metabolism and Ageing (Chrometa), Leuven Lung Transplant Unit, KU Leuven, Leuven, Belgium;Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium;BREATHE, Department of Chronic Diseases, Metabolism and Ageing (Chrometa), Leuven Lung Transplant Unit, KU Leuven, Leuven, Belgium;Lung Transplant Unit, Hospital Universitari Vall D’Hebron, Barcelona, Spain;Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium;Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium;Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium;Laboratory of Virology and Chemotherapy, Department of Microbiology and Immunology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium;

关键词: Porcine left lung transplantation;    Primary graft dysfunction;    Pulmonary vascular resistance;   

DOI  :  10.1186/s40635-021-00371-1

来源: Springer

【 摘 要 】

BackgroundPrimary 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.MaterialsTwelve 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.ResultsSurvival 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.ConclusionsPartial 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.

【 授权许可】

CC BY