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ex-vivo lung perfusion

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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
#1
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/28314503/standard-donor-lung-procurement-with-normothermic-ex-vivo-lung-perfusion-a-prospective-randomized-clinical-trial
#2
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
#3
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...
March 15, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28291795/experimental-chronic-kidney-disease-attenuates-ischemia-reperfusion-injury-in-an-ex-vivo-rat-lung-model
#4
Chung-Kan Peng, Kun-Lun Huang, Chou-Chin Lan, Yu-Juei Hsu, Geng-Chin Wu, Chia-Hui Peng, Chin-Pyng Wu, Khee-Siang Chan
Lung ischemia reperfusion injury (LIRI) is one of important complications following lung transplant and cardiopulmonary bypass. Although patients on hemodialysis are still excluded as lung transplant donors because of the possible effects of renal failure on the lungs, increased organ demand has led us to evaluate the influence of chronic kidney disease (CKD) on LIRI. A CKD model was induced by feeding Sprague-Dawley rats an adenine-rich (0.75%) diet for 2, 4 and 6 weeks, and an isolated rat lung in situ model was used to evaluate ischemia reperfusion (IR)-induced acute lung injury...
2017: PloS One
https://www.readbyqxmd.com/read/28266040/ex-vivo-porcine-organ-perfusion-models-as-a-suitable-platform-for-translational-transplant-research
#5
Rohan Kumar, Wen Yuan Chung, Ashley Robert Dennison, Giuseppe Garcea
In transplantation surgery, extending the criteria for organ donation to include organs that may have otherwise been previously discarded has provided the impetus to improve organ preservation. The traditional method of cold static storage (CS) has been tried and tested and is suitable for organs meeting standard criteria donation. Ex vivo machine perfusion is, however, associated with evidence suggesting that it may be better than CS alone and may allow for organ donation criteria to be extended. Much of our knowledge of organ preservation is derived from animal studies...
March 6, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28258595/transgenic-expression-of-human-leukocyte-antigen-e-attenuates-galko-hcd46-porcine-lung-xenograft-injury
#6
Christopher T Laird, Lars Burdorf, Beth M French, Natalia Kubicki, Xiangfei Cheng, Gheorghe Braileanu, Wenji Sun, Natalie A O'Neill, Arielle Cimeno, Dawn Parsell, Edward So, Andrea Bähr, Nikolai Klymiuk, Carol J Phelps, David Ayares, Agnes M Azimzadeh, Richard N Pierson
BACKGROUND: Lung xenografts remain susceptible to loss of vascular barrier function within hours in spite of significant incremental advances based on genetic engineering to remove the Gal 1,3-αGal antigen (GalTKO) and express human membrane cofactor protein (hCD46). Natural killer cells rapidly disappear from the blood during perfusion of GalTKO.hCD46 porcine lungs with human blood and presumably are sequestered within the lung vasculature. Here we asked whether porcine expression of the human NK cell inhibitory ligand HLA-E and β2 microglobulin inhibits GalTKO...
March 3, 2017: Xenotransplantation
https://www.readbyqxmd.com/read/28242077/ex%C3%A2-vivo-lung-perfusion-model-to-study-pulmonary-tissue-extracellular-microvesicle-profiles
#7
Prashanth Vallabhajosyula, Laxminarayana Korutla, Andreas Habertheuer, Sanjana Reddy, Christian Shaufler, 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...
February 24, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28238726/ex-vivo-lung-perfusion-a-key-tool-for-translational-science-in-the-lungs
#8
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
https://www.readbyqxmd.com/read/28074663/primary-graft-dysfunction-pathophysiology-to-guide-new-preventive-therapies
#9
Ciara M Shaver, Lorraine B Ware
Primary graft dysfunction (PGD) is a common complication of lung transplantation characterized by acute pulmonary edema associated with bilateral pulmonary infiltrates and hypoxemia in the first 3 post-operative days. Development of PGD is a predictor of poor short- and long-term outcomes after lung transplantation, but there are currently limited tools to prevent its occurrence. Areas covered: Several potentially modifiable donor, recipient, and operative risk factors for PGD have been identified. In addition, basic and translational studies in animals and ex vivo lung perfusion systems have identified several biomarkers and mechanisms of injury in PGD...
February 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28052693/safety-and-efficacy-of-ex-vivo-donor-lung-adenoviral-il-10-gene-therapy-in-a-large-animal-lung-transplant-survival-model
#10
Tiago N Machuca, Marcelo Cypel, Riccardo Bonato, Jonathan C Yeung, Yi-Min Chun, Stephen Juvet, Zehong Guan, David M Hwang, Manyin Chen, Tomohito Saito, Constantine Harmantas, Beverly L Davidson, Thomas K Waddell, Mingyao Liu, Shaf Keshavjee
Ex vivo normothermic lung perfusion (EVLP) is a novel platform and method developed to facilitate functional assessment and implementation of advanced therapies for donor lungs prior to transplantation. This study aimed to determine the safety and immunological and functional benefits of ex vivo adenoviral human interleukin-10 (AdhIL-10) gene delivery to prevent the development of primary graft dysfunction in a large animal survival model. Pig donor lungs were retrieved, preserved for 6 h at 4°C, and then randomly assigned to four groups: (1) AdhIL-10 gene therapy: 12 h EVLP + AdhIL-10 intra-bronchial delivery; (2) EVLP-control: 12 h EVLP; (3) Vector-control: 12 h EVLP + adenoviral vector intra-bronchial delivery; and (4) prolonged hypothermic preservation: additional 12 h of cold ischemia...
January 4, 2017: Human Gene Therapy
https://www.readbyqxmd.com/read/28041954/lung-lavage-and-surfactant-replacement-during-ex-vivo-lung-perfusion-for-treatment-of-gastric-acid-aspiration-induced-donor-lung-injury
#11
Daisuke Nakajima, Mingyao Liu, Akihiro Ohsumi, Ricardo Kalaf, Ilker Iskender, Michael Hsin, Takashi Kanou, Manyin Chen, Brandon Baer, Rafael Coutinho, Lucas Maahs, Paula Behrens, Sassan Azad, Tereza Martinu, Thomas K Waddell, James F Lewis, Martin Post, Ruud A W Veldhuizen, Marcelo Cypel, Shaf Keshavjee
BACKGROUND: Ex vivo lung perfusion (EVLP) provides opportunities to treat injured donor lungs before transplantation. We investigated whether lung lavage, to eliminate inflammatory inhibitory components, followed by exogenous surfactant replacement, could aid lung recovery and improve post-transplant lung function after gastric aspiration injury. METHODS: Gastric acid aspiration was induced in donor pigs, which were ventilated for 6 hours to develop lung injury...
December 1, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28017342/will-ex-vivo-lung-perfusion-allow-a-move-towards-daytime-lung-transplantation-surgery
#12
Peter Riddell, Jim J Egan
No abstract text is available yet for this article.
February 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28009782/prolonged-evlp-using-ocs-lung-cellular-and-acellular-perfusates
#13
Gabriel Loor, Brian T Howard, John R Spratt, Lars M Mattison, Angela Panoskaltsis-Mortari, Roland Z Brown, Tinen L Iles, Carolyn M Meyer, Haylie Helms, Andrew Price, Paul A Iaizzo
BACKGROUND: We report the ability to extend lung preservation up to 24 hours (24H) by using autologous whole donor blood circulating within an ex vivo lung perfusion (EVLP) system. This approach facilitates donor lung reconditioning in a model of extended normothermic EVLP. We analyzed comparative responses to cellular and acellular perfusates to identify these benefits. METHODS: Twelve pairs of swine lungs were retrieved after cardiac arrest and studied for 24H on the Organ Care System (OCS) Lung EVLP platform...
December 22, 2016: Transplantation
https://www.readbyqxmd.com/read/27977885/soluble-adhesion-molecules-during-ex-vivo-lung-perfusion-are-associated-with-posttransplant-primary-graft-dysfunction
#14
K Hashimoto, M Cypel, H Kim, T N Machuca, D Nakajima, M Chen, M K Hsin, R Zamel, S Azad, T K Waddell, M Liu, S Keshavjee
Ex vivo lung perfusion (EVLP) enables assessment of marginal donor lungs for transplantation. We aimed to discover biomarkers in EVLP perfusate that could predict development of primary graft dysfunction (PGD). From September 2008 to August 2013, 100 clinical EVLPs were performed. Eleven patients developed PGD grade 3 within 72 h after transplant. The non-PGD group consisted of 34 patients without PGD grade 3. Nonbilateral lung transplants or transplant after extracorporeal life support were excluded from analyses...
December 15, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27943597/re-endothelialization-of-rat-lung-scaffolds-through-passive-gravity-driven-seeding-of-segment-specific-pulmonary-endothelial-cells
#15
Michelle E Scarritt, Nicholas C Pashos, Jessica M Motherwell, Zachary R Eagle, Brian J Burkett, Ashley N Gregory, Ricardo Mostany, Daniel J Weiss, Diego F Alvarez, Bruce A Bunnell
Effective re-endothelialization is critical for the use of decellularized scaffolds for ex vivo lung engineering. Current approaches yield insufficiently re-endothelialized scaffolds that hemorrhage and become thrombogenic upon implantation. Herein, gravity-driven seeding coupled with bioreactor culture facilitated widespread distribution and engraftment of endothelial cells throughout rat lung scaffolds. Initially, human umbilical vein endothelial cells (HUVECs) were seeded into the pulmonary artery by either gravity-driven, variable flow perfusion seeding or pump-driven, pulsatile flow perfusion seeding...
December 12, 2016: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/27936178/ex-vivo-lung-perfusion-in-the-rat-detailed-procedure-and-videos
#16
Giulia Alessandra Bassani, Caterina Lonati, Daniela Brambilla, Francesca Rapido, Franco Valenza, Stefano Gatti
Ex vivo lung perfusion (EVLP) is a promising procedure for evaluation, reconditioning, and treatment of marginal lungs before transplantation. Small animal models can contribute to improve clinical development of this technique and represent a substantial platform for bio-molecular investigations. However, to accomplish this purpose, EVLP models must sustain a prolonged reperfusion without pharmacological interventions. Currently available protocols only partly satisfy this need. The aim of the present research was accomplishment and optimization of a reproducible model for a protracted rat EVLP in the absence of anti-inflammatory treatment...
2016: PloS One
https://www.readbyqxmd.com/read/27917620/normothermic-ex-vivo-lung-perfusion-in-brain-dead-donors-reduces-inflammatory-cytokines-and-toll-like-receptor-expression
#17
Shadi Shafaghi, Esmaeil Mortaz, Azizollah Abbasi Dezfuli, Hoda Godarzi, Kambiz Sheikhy, Zahra Ansari Aval, Behrooz Farzanegan, Habib Emami, Fatemeh Sadat Hosseini-Baharanchi, Katayoun Najafizadeh
Inflammatory responses and innate immunologic reactions play an important role in the respiratory system. Ex vivo lung perfusion (EVLP) is considered a novel method in the evaluation and reconditioning of donor lungs prior to transplantation. However, EVLP's effect on inflammatory and metabolic markers of human lung tissue is unknown.  This study investigated how the performance of EVLP on brain-dead (BD) donor lungs affects the production and release of inflammatory cytokines (IL-6, IL-8, and TNF-a), inflammatory cells and toll-like receptors (TLR) -2, 4...
October 2016: Iranian Journal of Allergy, Asthma, and Immunology
https://www.readbyqxmd.com/read/27916039/-the-development-of-ex-vivo-lung-perfusion-in-lung-transplantation
#18
X F Pan, R Wang, S J Fu, Y H Yang, J Yang, H Zhao
The shortage of donor lung remains one of the major problem for lung transplantation. With the development of modern lung preservation and repair technique, increasing marginal lung donors have been re-assessed and finally utilized for transplantation. The ex vivo lung perfusion technique (EVLP) was designed and has been developed for evaluation and repair of the lung. Nowadays, the indication of EVLP and the standard of qualified donor lung have reached a consensus according to the foreign publications. The EVLP system could be classified into three categories: the Toronto technique, the Lund technique and Hannover-Madrid technique...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27916027/-current-status-of-lung-transplantation-in-china-problems-and-perspectives
#19
X A Wang, G N Jiang
Despite rapid progress, clinical lung transplantation in China still lags far behind. A great challenge remains in donor lung utilization and perioperative medicine. It's really abnormal that we are so backward in lung transplantation when we have come up with the advanced world levels in thoracic surgery, pulmonology and critical care medicine. Our shortcomings were analyzed by comparing lung transplantation in China and in the advanced countries. The first problem is multidisciplinary teamwork. In the United States, a lung transplant team includes physician specialized in lung transplantation, thoracic surgeons, nurses, respiratory therapists and other specialists possibly needed...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27914896/optimal-ex-vivo-lung-perfusion-techniques-with-oxygenated-perfusate
#20
Kentaro Noda, Shinya Tane, Seok Jin Haam, Awori J Hayanga, Jonathan D'Cunha, James D Luketich, Norihisa Shigemura
BACKGROUND: Accumulating evidence supports an increasing role of ex vivo lung perfusion (EVLP) in clinical lung transplantation. However, EVLP has adverse effects on the quality of lung grafts, which have rarely been discussed. Careful optimization of current EVLP protocols might improve outcomes. This study examined effects of different levels of oxygenation of the perfusate circulated through the lungs during EVLP and the impact on post-transplant functional outcomes. METHODS: We compared results of 4 different oxygenation levels in the perfusate during EVLP: 6% oxygen (O2), 40% O2, 60% O2, and 100% O2...
October 29, 2016: Journal of Heart and Lung Transplantation
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