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https://www.readbyqxmd.com/read/28756120/comparison-of-two-strategies-for-ex-vivo-lung-perfusion
#1
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
#2
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
#3
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
#4
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
#5
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-evlp-to-recruit-declined-lung-donors
#6
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
BACKGROUND: 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. METHODS: 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
#7
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...
May 12, 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
#8
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
https://www.readbyqxmd.com/read/28521795/ex-vivo-recruitment-and-x-ray-assessment-of-donor-lungs-in-a-challenging-retrieval-from-a-donor-supported-by-lvad-using-the-portable-normothermic-perfusion-system-a-case-report
#9
Marco Schiavon, Francesca Calabrese, Guido Di Gregorio, Monica Loy, Giuseppe Marulli, Alessandro Rebusso, Fiorella Calabrese, Federico Rea
BACKGROUND: Lung transplantation (LTx) is limited by the shortage of suitable donors. To overcome this problem, many programs have begun to use donors with extended criteria (marginal donors). However, brain-dead patients with implanted mechanical circulatory support system have rarely been considered as potential lung donors. This case demonstrates the feasibility of lung transplantations from organ donors supported by a mechanical circulatory support system despite the possible difficulties of lung retrieval...
May 18, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28493634/an-experimental-study-of-the-recovery-of-injured-porcine-lungs-with-prolonged-normothermic-cellular-ex%C3%A2-vivo-lung-perfusion-following-donation-after-circulatory-death
#10
John R Spratt, Lars M Mattison, Paul A Iaizzo, Roland Z Brown, Haylie Helms, Tinen L Iles, Brian Howard, Angela Panoskaltsis-Mortari, Gabriel Loor
Donation after circulatory death (DCD) is an underused source of donor lungs. Normothermic cellular ex vivo lung perfusion (EVLP) is effective in preserving standard donor lungs but may also be useful in the preservation and assessment of DCD lungs. Using a model of DCD and prolonged EVLP, the effects of donor warm ischemia and postmortem ventilation on graft recovery were evaluated. Adult male swine underwent general anesthesia and heparinization. In the control group (n = 4), cardioplegic arrest was induced and the lungs were procured immediately...
September 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28483262/lungs-donated-after-circulatory-death-and-prolonged-warm-ischemia-are-transplanted-successfully-after-enhanced-ex%C3%A2-vivo-lung-perfusion-using-adenosine-a2b-receptor-antagonism
#11
Eric J Charles, J Hunter Mehaffey, Ashish K Sharma, Yunge Zhao, Mark H Stoler, James M Isbell, Christine L Lau, Curtis G Tribble, Victor E Laubach, Irving L Kron
OBJECTIVE: The current supply of acceptable donor lungs is not sufficient for the number of patients awaiting transplantation. We hypothesized that ex vivo lung perfusion (EVLP) with targeted drug therapy would allow successful rehabilitation and transplantation of donation after circulatory death lungs exposed to 2 hours of warm ischemia. METHODS: Donor porcine lungs were procured after 2 hours of warm ischemia postcardiac arrest and subjected to 4 hours of cold preservation or EVLP...
April 12, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28480029/a-porcine-ex-vivo-lung-perfusion-model-with-maximal-argon-exposure-to-attenuate-ischemia-reperfusion-injury
#12
An Martens, Sofie Ordies, Bart M Vanaudenaerde, Stijn E Verleden, Robin Vos, Geert M Verleden, Eric K Verbeken, Dirk E Van Raemdonck, Sandra Claes, Dominique Schols, Matthieu Chalopin, Ira Katz, Geraldine Farjot, Arne P Neyrinck
Argon (Ar) is a noble gas with known organoprotective effects in rodents and in vitro models. In a previous study we failed to find a postconditioning effect of Ar during ex vivo lung perfusion (EVLP) on warm-ischemic injury in a porcine model. In this study, we further investigated a prolonged exposure to Ar to decrease cold ischemia-reperfusion injury after lung transplantation in a porcine model with EVLP assessment. Domestic pigs (n = 6/group) were pre-conditioned for 6 hours with 21% O2 and 79% N2 (CONTR) or 79% Ar (ARG)...
January 2017: Medical Gas Research
https://www.readbyqxmd.com/read/28452921/targeting-circulating-leukocytes-and-pyroptosis-during-ex-vivo-lung-perfusion-improves-lung-preservation
#13
Kentaro Noda, Shinya Tane, Seok Jin Haam, Jonathan D'Cunha, Awori J Hayanga, James D Luketich, Norihisa Shigemura
BACKGROUND: The role of the circulating leukocytes in lungs and their relationship with circulating proinflammatory cytokines during ischemia-reperfusion injury is not well understood. Using ex vivo lung perfusion (EVLP) to investigate the pathophysiology of isolated lungs, we aimed to identify a therapeutic target to optimize lung preservation leading to successful lung transplantation. METHODS: Rat heart-lung blocks were placed on EVLP for 4 hours with or without a leukocyte-depleting filter (LF)...
April 27, 2017: Transplantation
https://www.readbyqxmd.com/read/28434548/ex%C3%A2-vivo-lung-perfusion-rehabilitates-sepsis-induced-lung-injury
#14
J Hunter Mehaffey, Eric J Charles, Ashish K Sharma, Morgan Salmon, Dustin Money, Sarah Schubert, Mark H Stoler, Curtis G Tribble, Victor E Laubach, Mark E Roeser, Irving L Kron
BACKGROUND: Sepsis is the number one cause of lung injury in adults. Ex vivo lung perfusion (EVLP) is gaining clinical acceptance for donor lung evaluation and rehabilitation and may expand the use of marginal organs for transplantation. We hypothesized that 4 hours of normothermic EVLP would improve compliance and oxygenation in a porcine model of sepsis-induced lung injury. METHODS: We used intravenous lipopolysaccharide (LPS) to induce a systemic inflammatory response in a porcine model of lung injury...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28323904/pyrrolidine-dithiocarbamate-administered-during-ex-vivo-lung-perfusion-promotes-rehabilitation-of-injured-donor-rat-lungs-obtained-after-prolonged-warm-ischemia
#15
Cyril Francioli, Xingyu Wang, Roumen Parapanov, Etienne Abdelnour, Jérôme Lugrin, Fabrizio Gronchi, Jean Perentes, Philippe Eckert, Hans-Beat Ris, Lise Piquilloud, Thorsten Krueger, Lucas Liaudet
Damaged lung grafts obtained after circulatory death (DCD lungs) and warm ischemia may be at high risk of reperfusion injury after transplantation. Such lungs could be pharmacologically reconditioned using ex-vivo lung perfusion (EVLP). Since acute inflammation related to the activation of nuclear factor kappaB (NF-κB) is instrumental in lung reperfusion injury, we hypothesized that DCD lungs might be treated during EVLP by pyrrolidine dithiocarbamate (PDTC), an inhibitor of NF-κB. Rat lungs exposed to 1h warm ischemia and 2 h cold ischemia were subjected to EVLP during 4h, in absence (CTRL group, N = 6) or in presence of PDTC (2...
2017: PloS One
https://www.readbyqxmd.com/read/28322021/cytoprotective-and-antioxidant-effects-of-steen-solution-on-human-lung-spheroids-and-human-endothelial-cells
#16
F Pagano, C Nocella, S Sciarretta, L Fianchini, C Siciliano, G Mangino, M Ibrahim, E De Falco, R Carnevale, I Chimenti, G Frati
Respiratory diseases represent a major healthcare burden worldwide. Lung transplantation (LTx) is the "gold standard" for end-stage patients, strongly limited by shortage of available/suitable donor lungs. Normothermic ex vivo lung perfusion (EVLP) has significantly increased the number of lungs suitable for transplantation. Steen solution is used for EVLP, but the mechanisms involved in its beneficial properties remain to be clarified. We investigated the effects of Steen solution in an in vitro protocol of cold starvation and normothermic recovery on human lung spheroids, named pneumospheres (PSs), containing epithelial/basal cells, and on endothelial human umbilical vein endothelial cells (HUVEC)...
July 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28314503/standard-donor-lung-procurement-with-normothermic-ex-vivo-lung-perfusion-a-prospective-randomized-clinical-trial
#17
Alexis Slama, Lukas Schillab, Maximilian Barta, Aris Benedek, Andreas Mitterbauer, Konrad Hoetzenecker, Shahrokh Taghavi, Gyoergy Lang, Jose Matilla, Hendrik Ankersmit, Helmut Hager, Georg Roth, Walter Klepetko, Clemens Aigner
BACKGROUND: Ex vivo lung perfusion (EVLP) was primarily developed for evaluation of impaired donor lungs. The good clinical results raise the question for its possible impact on lungs meeting standard criteria. Before application of EVLP on such lungs enters routine clinical practice, it must be demonstrated whether EVLP would affect or improve outcome when used in standard donor lungs. We performed a prospective randomized trial to investigate the role of EVLP in standard lung transplantation (Tx)...
February 20, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28301389/ex-vivo-lung-perfusion-the-model-for-the-organ-reconditioning-hub
#18
Jonathan C Yeung, Marcelo Cypel, Shaf Keshavjee
PURPOSE OF REVIEW: Lung evaluation and reconditioning by ex-vivo lung perfusion (EVLP) is becoming increasingly established. We review strategies for broader implementation of this technology to transplant centers worldwide. RECENT FINDINGS: The organ reconditioning hub model is a viable strategy for disseminating EVLP to small and large transplant centers given the well tolerated prolongation of preservation time afforded by EVLP. Regulatory and process issues remain hurdles to be overcome...
June 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28242077/ex%C3%A2-vivo-lung-perfusion-model-to-study-pulmonary-tissue-extracellular-microvesicle-profiles
#19
Prashanth Vallabhajosyula, Laxminarayana Korutla, Andreas Habertheuer, Sanjana Reddy, Christian Schaufler, Jared Lasky, Joshua Diamond, Edward Cantu
BACKGROUND: Extracellular microvesicles (EVs) are being increasingly studied for their diagnostic potential. We investigated the feasibility of studying the kinetics and tissue-specific profiles of pulmonary EVs in the context of ex vivo lung perfusion (EVLP) used for salvaging marginal lungs for transplantation. METHODS: Perfusate from six marginal donor lungs placed on EVLP was collected at the following time points: 0, 10, and 60 minutes after and after perfusate exchange with Steen Solution; 120 and 180 minutes...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28238726/ex-vivo-lung-perfusion-a-key-tool-for-translational-science-in-the-lungs
#20
Shinya Tane, Kentaro Noda, Norihisa Shigemura
Ex vivo lung perfusion (EVLP) promises to be a comprehensive platform for assessment, re-conditioning, and preservation for donor lungs and has been dramatically changing the face of clinical lung transplantation. Besides its increasing role in lung transplantation, EVLP has also been recognized as a useful tool for translational research involving the lungs. Based on recent remarkable evidence and experience using EVLP in lung transplantation, there is growing interest in and expectations for the use of EVLP beyond the field of lung transplantation...
February 23, 2017: Chest
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