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https://www.readbyqxmd.com/read/29103845/negative-pressure-ventilation-decreases-inflammation-and-lung-edema-during-normothermic-ex-vivo-lung-perfusion
#1
Nader S Aboelnazar, Sayed Himmat, Sanaz Hatami, Christopher W White, Mohamad S Burhani, Peter Dromparis, Nobutoshi Matsumura, Ganghong Tian, Jason R B Dyck, Michael Mengel, Darren H Freed, Jayan Nagendran
BACKGROUND: Normothermic ex-vivo lung perfusion (EVLP) using positive pressure ventilation (PPV) and both acellular and red blood cell (RBC)-based perfusate solutions have increased the rate of donor organ utilization. We sought to determine whether a negative pressure ventilation (NPV) strategy would improve donor lung assessment during EVLP. METHODS: Thirty-two pig lungs were perfused ex vivo for 12 hours in a normothermic state, and were allocated equally to 4 groups according to the mode of ventilation (positive pressure ventilation [PPV] vs NPV) and perfusate composition (acellular vs RBC)...
September 14, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29101307/combining-high-resolution-cryo-electron-microscopy-and-mutagenesis-to-develop-cowpea-mosaic-virus-for-bionanotechnology
#2
REVIEW
Yulia Meshcheriakova, Alex Durrant, Emma L Hesketh, Neil A Ranson, George P Lomonossoff
Particles of cowpea mosaic virus (CPMV) have enjoyed considerable success as nanoparticles. The development of a system for producing empty virus-like particles (eVLPs) of the virus, which are non-infectious and have the potential to be loaded with heterologous material, has increased the number of possible applications for CPMV-based particles. However, for this potential to be realised, it was essential to demonstrate that eVLPs were accurate surrogates for natural virus particles, and this information was provided by high-resolution cryo-EM studies of eVLPs...
November 3, 2017: Biochemical Society Transactions
https://www.readbyqxmd.com/read/28985871/ex%C3%A2-vivo-treatment-with-inhaled-n-acetylcysteine-in-porcine-lung-transplantation
#3
Yoshito Yamada, Ilker Iskender, Stephan Arni, Sven Hillinger, Tugba Cosgun, Keke Yu, Wolfgang Jungraithmayr, Nikola Cesarovic, Walter Weder, Ilhan Inci
BACKGROUND: We have shown the beneficial effects of N-acetylcysteine (NAC) on posttransplant lung function, when both donor and recipient were pretreated intravenously. However, systemic treatment of multiorgan donors may not be clinically relevant. Thus, we hypothesized that ex vivo treatment of donors with nebulized NAC would be adequate to prevent from ischemia-reperfusion injury after lung transplantation. METHODS: Lungs were retrieved from domestic pigs and stored at 4°C for 24 h followed by 2 h of ex vivo lung perfusion (EVLP) to administer 50 mg/kg of NAC via nebulization in the NAC group (n = 6)...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28964417/continued-successful-evolution-of-extended-criteria-donor-lungs-for-transplantation
#4
Sakhee Kotecha, Jamie Hobson, Jeremy Fuller, Eldho Paul, Bronwyn J Levvey, Helen Whitford, Miranda Paraskeva, David McGiffin, Gregory I Snell, Glen P Westall
BACKGROUND: In an era of increasing ex vivo lung perfusion (EVLP) use, it remains important to describe what outcomes can be achieved without EVLP, by taking an aggressive approach to donor use to maximize lung transplantation. METHODS: Data for all lung transplant donor referrals to the Alfred Hospital in Melbourne, Australia were collected for 2012 to 2013. Donor variables were analyzed and calculated into a previously validated lung donor score. Lung transplant recipient outcome data included the following: primary graft dysfunction; duration of mechanical ventilation; need for cardiopulmonary bypass extracorporeal membrane oxygenation; intensive care and hospital length of stay; 30-day, 1-year, and 3- to 4-year survival rates; rates of acute rejection and chronic lung allograft dysfunction; and peak and 12-month lung function (forced expiratory volume in 1 second)...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28945476/assessment-of-lungs-for-transplant-recovered-from-uncontrolled-donation-after-circulatory-determination-of-death-donors
#5
Thomas Egan, John Blackwell, Katherine Birchard, Benjamin Haithcock, Jason Long, Stephen Gazda, Nissa Casey, Caitlin Thys
RATIONALE: To address the lung donor shortage, we obtained institutional review board and US Food and Drug Administration approval to transplant lungs recovered from uncontrolled donation after circulatory determination of death donors (uDCDDs). OBJECTIVES: To compare outcomes of recipients of lungs recovered from uDCDDs vs. brain-dead donors. METHODS: After consent and screening, lungs recovered from uDCDDs were assessed by 4 hours ex vivo lung perfusion (EVLP) and computed tomography (CT) scan...
September 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28936437/ex-vivo-lung-perfusion-review-of-a-revolutionary-technology
#6
REVIEW
George Makdisi, Tony Makdisi, Tambi Jarmi, Christiano C Caldeira
Donor lung shortage has been the main reason to the increasing number of patients waiting for lung transplant. Ex vivo lung perfusion (EVLP) is widely expanding technology to assess and prepare the lungs who are considered marginal for transplantation. the outcomes are encouraging and comparable to the lungs transplanted according to the standard criteria. in this article, we will discuss the history of development, the techniques and protocols of ex vivo, and the logics and rationales for ex vivo use.
September 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28923643/feasibility-of-lung-transplantation-from-donation-after-circulatory-death-donors-following-portable-ex%C3%A2-vivo-lung-perfusion-a-pilot-study
#7
J G Y Luc, K Jackson, J G Weinkauf, D H Freed, J Nagendran
BACKGROUND: Donation after circulatory death (DCD) has the potential to significantly alleviate the shortage of transplantable lungs. We report our initial experience with the use of portable ex vivo lung perfusion (EVLP) with the Organ Care System Lung device for evaluation of DCD lungs. METHODS: We performed a retrospective review of the DCD lung transplantation (LTx) experience at a single institution through the use of a prospective database. RESULTS: From 2011 to 2015, 208 LTx were performed at the University of Alberta, of which 11 were DCD LTx with 7 (64%) that underwent portable EVLP...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28874022/ex-vivo-administration-of-trimetazidine-improves-post-transplant-lung-function-in-pig-model
#8
Tugba Cosgun, Ilker Iskender, Yoshito Yamada, Stephan Arni, Miriam Lipiski, Koen van Tilburg, Walter Weder, Ilhan Inci
OBJECTIVES: Ex vivo lung perfusion (EVLP) is not only used to assess marginal donor lungs but is also used as a platform to deliver therapeutic agents outside the body. We previously showed the beneficial effects of trimetazidine (TMZ) on ischaemia reperfusion (IR) injury in a rat model. This study evaluated the effects of TMZ in a pig EVLP transplant model. METHODS: Pig lungs were retrieved and stored for 24 h at 4°C, followed by 4 h of EVLP. Allografts were randomly allocated to 2 groups ( n  = 5 each)...
July 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28857775/ex-vivo-lung-perfusion-past-present-and-future
#9
Hannah C D'Cunha, Mauricio Rojas
Lung transplant is the only therapy for several end-stage lung diseases; however, the number of donated lungs suitable for transplant is not sufficient, and hundreds of patients have died waiting for an organ. Ex vivo lung perfusion (EVLP) has emerged as a new technology with the potential of reconditioning human donor lungs previously unsuitable for transplantation. Since the first successful transplant of a lung treated using EVLP in the year 2000, multiple clinical trials have demonstrated, in several transplant centers around the word, the feasibility and the potential of EVLP to increase the total number of lungs available for transplant...
August 29, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28855898/quantitative-analysis-of-repertoire-scale-immunoglobulin-properties-in-vaccine-induced-b-cell-responses
#10
Ilja V Khavrutskii, Sidhartha Chaudhury, Sabrina M Stronsky, Donald W Lee, Jacqueline G Benko, Anders Wallqvist, Sina Bavari, Christopher L Cooper
Recent advances in the next-generation sequencing of B-cell receptors (BCRs) enable the characterization of humoral responses at a repertoire-wide scale and provide the capability for identifying unique features of immune repertoires in response to disease, vaccination, or infection. Immunosequencing now readily generates 10(3)-10(5) sequences per sample; however, statistical analysis of these repertoires is challenging because of the high genetic diversity of BCRs and the elaborate clonal relationships among them...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28839932/the-impact-of-alteplase-on-pulmonary-graft-function-in-donation-after-circulatory-death-an-experimental-study
#11
Annika Liersch-Nordqvist, Mohammed Fakhro, Leif Pierre, Joanna Hlebowicz, Malin Malmsjo, Richard Ingemansson, Sandra Lindstedt
OBJECTIVE: Lung transplantation is hampered by the lack of organs resulting in deaths on the waiting list. The usage of donation after circulatory death (DCD) lungs would dramatically increase donor availability. The most optimal organ preservation method, and the need for antithrombotic and fibrinolytic treatment to prevent thrombosis in the donor lungs is currently on debate. The present study investigated, in a simulated clinical DCD situation, whether the addition of alteplase in the flush-perfusion solution at the time of pulmonary graft harvesting could prevent thrombosis in the donor lung and thereby improve pulmonary graft function...
October 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28838463/beware-cold-agglutinins-in-organ-donors-ex%C3%A2-vivo-lung-perfusion-from-an-uncontrolled-donation-after-circulatory-determination-of-death-donor-with-a-cold-agglutinin-a-case-report
#12
A Venkataraman, J W Blackwell, W K Funkhouser, K R Birchard, S E Beamer, W T Simmons, S H Randell, T M Egan
BACKGROUND: We began to recover lungs from uncontrolled donation after circulatory determination of death to assess for transplant suitability by means of ex vivo lung perfusion (EVLP) and computerized tomographic (CT) scan. Our first case had a cold agglutinin with an interesting outcome. CASE REPORT: A 60-year-old man collapsed at home and was pronounced dead by Emergency Medical Services personnel. Next-of-kin consented to lung retrieval, and the decedent was ventilated and transported...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28756120/comparison-of-two-strategies-for-ex-vivo-lung-perfusion
#13
Tobias Nilsson, Jan F Gielis, Alexis Slama, Christoffer Hansson, Andreas Wallinder, Sven-Erik Ricksten, Göran Dellgren
BACKGROUND: Two clinically used strategies for ex vivo lung perfusion (EVLP) were compared in a porcine model with respect to lung function, metabolism, inflammatory response, oxidative stress, and cell viability. METHODS: Porcine lungs (n = 20) were preserved, harvested, and kept cooled for 2 hours. After randomization, EVLP was performed using a cellular perfusate and open left atrium (COA group) or an acellular perfusate and a closed left atrium (ACA group). Oxygenation (partial pressure of arterial oxygen/fraction of inspired oxygen), compliance, dead space, weight, and perfusate oncotic pressure were registered before and after a 4-hour period of reconditioning...
July 8, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28689646/higher-m30-and-high-mobility-group-box-1-protein-levels-in-ex-vivo-lung-perfusate-are-associated-with-primary-graft-dysfunction-after-human-lung-transplantation
#14
Kohei Hashimoto, Marcelo Cypel, Stephen Juvet, Tomohito Saito, Ricardo Zamel, Tiago N Machuca, Michael Hsin, Hyunhee Kim, Thomas K Waddell, Mingyao Liu, Shaf Keshavjee
BACKGROUND: Ex vivo lung perfusion (EVLP) enables assessment of marginal donor lungs for transplantation, with similar clinical outcomes to conventional lung transplantation. We investigated whether cell death-related proteins in the EVLP perfusate could predict primary graft dysfunction (PGD) after transplantation. METHODS: M30 (indicating epithelial apoptosis), M65 (indicating total epithelial cell death), and high mobility group box 1 (HMGB-1, related to cell death and inflammation) protein levels in EVLP perfusate were measured by enzyme-linked immunosorbent assay and correlated with clinical outcomes...
June 21, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28676074/immunoregulatory-effects-of-multipotent-adult-progenitor-cells-in-a-porcine-ex-vivo-lung-perfusion-model
#15
An Martens, Sofie Ordies, Bart M Vanaudenaerde, Stijn E Verleden, Robin Vos, Dirk E Van Raemdonck, Geert M Verleden, Valerie D Roobrouck, Sandra Claes, Dominique Schols, Eric Verbeken, Catherine M Verfaillie, Arne P Neyrinck
BACKGROUND: Primary graft dysfunction (PGD) is considered to be the end result of an inflammatory response targeting the new lung allograft after transplant. Previous research has indicated that MAPC cell therapy might attenuate this injury by its paracrine effects on the pro-/anti-inflammatory balance. This study aims to investigate the immunoregulatory capacities of MAPC cells in PGD when administered in the airways. METHODS: Lungs of domestic pigs (n = 6/group) were subjected to 90 minutes of warm ischemia...
July 5, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28631618/exhaled-carbon-monoxide-is-correlated-with-ischemia-reperfusion-injuries-during-ex-vivo-lung-perfusion-in-pigs
#16
Maxime Maignan, Stéphane Gennai, Guillaume Debaty, Daniele Romanini, Marie Hélène Schmidt, Vivien Brenckmann, Angélique Brouta, Irène Ventrillard, Raphael Briot
Measurement of exhaled carbon monoxide (eCO) might help in the selection of lung grafts during ex vivo lung perfusion since its endogenous production is increased under ischemia reperfusion. The objective of this study was to measure eCO variations depending on the extent of lung ischemia reperfusion injuries. Using a porcine model and a laser spectrometer instrument, eCO was measured during ex vivo lung perfusion. eCO was compared after 30 min (D0) or 24 h (D1) of cold ischemia. The ability of eCO to distinguish lungs deemed suitable for transplantation was evaluated...
June 20, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28587802/cytokine-filtration-modulates-pulmonary-metabolism-and-edema-formation-during-ex-vivo-lung-perfusion
#17
Ilker Iskender, Tugba Cosgun, Stephan Arni, Michael Trinkwitz, Stefan Fehlings, Yoshito Yamada, Nikola Cesarovic, Keke Yu, Thomas Frauenfelder, Wolfgang Jungraithmayr, Walter Weder, Ilhan Inci
BACKGROUND: Ex vivo lung perfusion (EVLP) has improved the process of donor lung management. Cytokine accumulation during EVLP has been shown to correlate with worse outcome after lung transplantation. Our objective in this study was to test the safety and efficacy of cytokine filtration during EVLP in a large animal model. METHODS: Pig donor lungs were preserved for 24 hours at 4°C, followed by 12 hours of EVLP, according to the Toronto protocol. The perfusate was continuously run through an absorbent device (CytoSorb) via a veno-venous shunt from the reservoir in the filter group...
May 20, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28556538/a-retrospective-database-analysis-to-evaluate-the-potential-of-ex%C3%A2-vivo-lung-perfusion-to-recruit-declined-lung-donors
#18
An Martens, Dirk E Van Raemdonck, Jacqueline Smits, Stijn E Verleden, Robin Vos, Bart M Vanaudenaerde, Geert M Verleden, Karlien Degezelle, Bruno Desschans, Arne P Neyrinck
Ex vivo lung perfusion (EVLP) is currently used for both standard and extended-criteria donor (ECD) lungs. To enlarge the donor pool, we might have to extend the threshold for ECD donation. The purpose of this study was to estimate how many additional ECD lungs could be recruited by EVLP. We reviewed all multi-organ donors (MODs) from our collaborative donor hospitals (January 2010-June 2015). All unused lung donors were categorized using registered donor data and evaluated by two independent investigators to identify which lungs could be transplanted after EVLP...
May 27, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28551353/the-role-of-interleukin-1%C3%AE-as-a-predictive-biomarker-and-potential-therapeutic-target-during-clinical-ex-vivo-lung-perfusion
#19
Anders S I Andreasson, Lee A Borthwick, Colin Gillespie, Kasim Jiwa, Jonathan Scott, Paul Henderson, Jonny Mayes, Rosalba Romano, Marius Roman, Simi Ali, James E Fildes, Nandor Marczin, John H Dark, Andrew J Fisher
BACKGROUND: Extended criteria donor lungs deemed unsuitable for immediate transplantation can be reconditioned using ex vivo lung perfusion (EVLP). Objective identification of which donor lungs can be successfully reconditioned and will function well post-operatively has not been established. This study assessed the predictive value of markers of inflammation and tissue injury in donor lungs undergoing EVLP as part of the DEVELOP-UK study. METHODS: Longitudinal samples of perfusate, bronchoalveolar lavage, and tissue from 42 human donor lungs undergoing clinical EVLP assessments were analyzed for markers of inflammation and tissue injury...
September 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28528061/real-time-computed-tomography-highlights-pulmonary-parenchymal-evolution-during-ex%C3%A2-vivo-lung-reconditioning
#20
Edouard Sage, Julien De Wolf, Philippe Puyo, Pierre Bonnette, Matthieu Glorion, Nicolas Salley, Antoine Roux, Ngai Liu, Alain Chapelier
Ex vivo lung perfusion (EVLP) has been developed as a method to reassess and recondition marginal lungs. However, evaluation during procedures is limited to a combination of physiologic variables such as gas exchange, pulmonary mechanics, and pulmonary vascular resistance. The aim of this study was to analyze the feasibility of real-time computed tomographic (CT) imaging to improve the evaluation of the lung during EVLP procedures.
June 2017: Annals of Thoracic Surgery
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