Perfusate Exchange Does Not Improve Outcomes in 24-hour Ex Situ Lung Perfusion

IF 0.8 4区 医学 Q4 IMMUNOLOGY
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引用次数: 0

Abstract

Background

Reliable 24-hour preservation is required to optimize the rehabilitation potential of Ex Situ Lung Perfusion (ESLP). Other ESLP protocols include fresh perfusate replacement to counteract an accumulation of deleterious by-products. We describe the results of our reliable 24-hour negative pressure ventilation (NPV)-ESLP protocol with satisfactory acute post-transplant outcomes and investigate perfusate exchange (PE) as a modification to enhance prolonged ESLP.

Methods

Twelve pig lungs underwent 24 hours of NPV-ESLP using 1.5L of cellular perfusate (500 mL packed red blood cells and 1 L buffered perfusate). The Control (n = 6) had no PE; the PE (n = 6) had 500 mL replaced after 12 hours of NPV-ESLP with 1000 mL fresh perfusate. Three left lungs per group were transplanted.

Results

Results are reported as Control vs PE (mean ± SEM). Both groups demonstrated stable and acceptable oxygenation during 24 hours of ESLP with final PF ratios of 527.5 ± 42.19 and 488.4 ± 35.38 (P = .25). Final compliance measurements were 20.52 ± 3.59 and 18.55 ± 2.91 (P = .34). There were no significant differences in pulmonary artery pressure after 24 hours of ESLP (10.02 ± 2.69 vs 14.34 ± 1.64, P = .10), and pulmonary vascular resistance only differed significantly at T12 (417.6 ± 53.06 vs 685.4 ± 81.19, P = .02). Percentage weight gain between groups was similar (24.32 ± 8.4 and 45.33 ± 7.76, P = .07). Post-transplant left lung oxygenation was excellent (327.3 ± 14.62 and 313.3 ± 15.38, P = .28). There was no significant difference in % weight gain of lungs post-transplant (22.20 ± 7.22 vs 14.36 ± 9.96, P = .28).

Conclusion

Acceptable lung function was maintained during 24-hour NPV-ESLP and post-transplant regardless of PE.

灌注液交换不能改善 24 小时原位肺灌注的效果
背景:为了优化原位肺灌注(ESLP)的康复潜力,需要可靠的 24 小时保存。其他 ESLP 方案包括更换新鲜灌注液,以抵消有害副产品的积累。我们描述了可靠的 24 小时负压通气(NPV)-ESLP 方案的结果,该方案在移植后的急性期疗效令人满意,我们还研究了灌注液交换(PE)作为加强长时间 ESLP 的一种改良方法:12只猪肺使用1.5升细胞灌流液(500毫升包装红细胞和1升缓冲灌流液)进行了24小时的NPV-ESLP。对照组(n = 6)无 PE;PE 组(n = 6)在 NPV-ESLP 12 小时后用 1000 mL 新鲜灌流液替换 500 mL。每组移植三个左肺:结果:结果以对照组 vs PE(平均值 ± SEM)表示。在 24 小时 ESLP 期间,两组均表现出稳定且可接受的氧合,最终 PF 比率分别为 527.5 ± 42.19 和 488.4 ± 35.38(P = .25)。最终顺应性测量值分别为 20.52 ± 3.59 和 18.55 ± 2.91(P = .34)。ESLP 24 小时后,肺动脉压力无明显差异(10.02 ± 2.69 vs 14.34 ± 1.64,P = .10),肺血管阻力仅在 T12 时有明显差异(417.6 ± 53.06 vs 685.4 ± 81.19,P = .02)。两组的体重增加百分比相似(24.32 ± 8.4 和 45.33 ± 7.76,P = .07)。移植后左肺氧合良好(327.3 ± 14.62 和 313.3 ± 15.38,P = .28)。移植后肺重量增加百分比无明显差异(22.20 ± 7.22 vs 14.36 ± 9.96,P = .28):结论:在 24 小时 NPV-ESLP 和移植后,无论 PE 如何,肺功能均可维持在可接受的水平。
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来源期刊
Transplantation proceedings
Transplantation proceedings 医学-免疫学
CiteScore
1.70
自引率
0.00%
发文量
502
审稿时长
60 days
期刊介绍: Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.
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