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ex-vivo lung perfusion

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https://www.readbyqxmd.com/read/28074663/primary-graft-dysfunction-pathophysiology-to-guide-new-preventive-therapies
#1
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...
January 11, 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
#2
Tiago Noguchi Machuca, Marcelo Cypel, Riccardo Bonato, Jonathan C Yeung, Yi-Min Chun, Stephen Juvet, Guan Zehong, David M Hwang, Manyin Chen, Tomohito Saito, Constantine Harmantas, Beverly Davidson, Thomas K Waddell, Mingyao Liu, Shaf Keshavjee
OBJECTIVE: 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. We aimed to determine the safety and immunological and functional benefits of ex vivo adenoviral human IL-10 (AdhIL-10) gene delivery to prevent the development of primary graft dysfunction in a large animal survival model. METHODS: Pig donor lungs were retrieved, preserved for 6 hours at 4oC and then randomly assigned to 4 groups: 1) AdhIL-10 Gene Therapy: 12 hours EVLP + AdhIL-10 intra-bronchial delivery; 2) EVLP-control: 12 hours EVLP; 3) Vector-control: 12 hours EVLP + adenoviral vector intra-bronchial delivery; and 4) Prolonged hypothermic preservation: Additional 12 hours 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
#3
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
#4
Peter Riddell, Jim J Egan
No abstract text is available yet for this article.
December 21, 2016: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28009782/prolonged-evlp-using-ocs-lung-cellular-and-acellular-perfusates
#5
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-post-transplant-primary-graft-dysfunction
#6
Kohei Hashimoto, Marcelo Cypel, Hyunhee Kim, Tiago N Machuca, Daisuke Nakajima, Manyin Chen, Michael K Hsin, Ricardo Zamel, Sassan Azad, Thomas K Waddell, Mingyao Liu, Shaf 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 EVLP were performed. Eleven patients developed PGD grade 3 within 72 h after transplant. Non-PGD group consisted of 34 patients without PGD grade 3. Non-bilateral 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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/27897967/an-observational-study-of-donor-ex-vivo-lung-perfusion-in-uk-lung-transplantation-develop-uk
#13
Andrew Fisher, Anders Andreasson, Alexandros Chrysos, Joanne Lally, Chrysovalanto Mamasoula, Catherine Exley, Jennifer Wilkinson, Jessica Qian, Gillian Watson, Oli Lewington, Thomas Chadwick, Elaine McColl, Mark Pearce, Kay Mann, Nicola McMeekin, Luke Vale, Steven Tsui, Nizar Yonan, Andre Simon, Nandor Marczin, Jorge Mascaro, John Dark
BACKGROUND: Many patients awaiting lung transplantation die before a donor organ becomes available. Ex vivo lung perfusion (EVLP) allows initially unusable donor lungs to be assessed and reconditioned for clinical use. OBJECTIVE: The objective of the Donor Ex Vivo Lung Perfusion in UK lung transplantation study was to evaluate the clinical effectiveness and cost-effectiveness of EVLP in increasing UK lung transplant activity. DESIGN: A multicentre, unblinded, non-randomised, non-inferiority observational study to compare transplant outcomes between EVLP-assessed and standard donor lungs...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27866861/outcomes-after-transplantation-of-lungs-preserved-for-more-than-12-h-a-retrospective-study
#14
Jonathan C Yeung, Thorsten Krueger, Kazuhiro Yasufuku, Marc de Perrot, Andrew F Pierre, Thomas K Waddell, Lianne G Singer, Shaf Keshavjee, Marcelo Cypel
BACKGROUND: Ex-vivo lung perfusion (EVLP) can be used to extend overall lung preservation time by splitting one long cold ischaemic time into two shorter ones and interposing an additional EVLP time. We assessed the outcomes after clinical transplantation of lungs with more than 12 h of preservation time. METHODS: For this retrospective study, we searched the Toronto Lung Transplant Program database for patients who had received at least one lung transplant between Jan 1, 2006, and April 30, 2015, at a single hospital in Toronto, Canada...
November 17, 2016: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/27768066/long-term-high-resolution-intravital-microscopy-in-the-lung-with-a-vacuum-stabilized-imaging-window
#15
Carolina Rodriguez-Tirado, Takanori Kitamura, Yu Kato, Jeffery W Pollard, John S Condeelis, David Entenberg
Metastasis to secondary sites such as the lung, liver and bone is a traumatic event with a mortality rate of approximately 90% (1). Of these sites, the lung is the most difficult to assess using intravital optical imaging due to its enclosed position within the body, delicate nature and vital role in sustaining proper physiology. While clinical modalities (positron emission tomography (PET), magnetic resonance imaging (MRI) and computed tomography (CT)) are capable of providing noninvasive images of this tissue, they lack the resolution necessary to visualize the earliest seeding events, with a single pixel consisting of nearly a thousand cells...
October 6, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27759556/ex-vivo-lung-perfusion-establishment-and-operationalization-in-iran
#16
Shadi Shafaghi, Azizollah Abbasi Dezfuli, Zahra Ansari Aval, Kambiz Sheikhy, Behrooz Farzanegan, Esmaeil Mortaz, Habib Emami, Clemens Aigner, Fatemeh Sadat Hosseini-Baharanchi, Katayoun Najafizadeh
OBJECTIVES: Although the number of lung transplants is limited because of general shortage of organ donors, ex vivo lung perfusion is a novel method with 2 main benefits, including better evaluation of lung potential and recovery of injured lungs. The main aim of this study was to establish and operationalize ex vivo lung perfusion as the first experience in Iran. MATERIALS AND METHODS: This was a prospective operational research study on 5 cases, including 1 pig from Vienna Medical University and 4 patients from Masih Daneshvari Hospital...
October 14, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27742245/airway-pressure-release-ventilation-during-ex%C3%A2-vivo-lung-perfusion-attenuates-injury
#17
J Hunter Mehaffey, Eric J Charles, Ashish K Sharma, Dustin T Money, Yunge Zhao, Mark H Stoler, Christine L Lau, Curtis G Tribble, Victor E Laubach, Mark E Roeser, Irving L Kron
OBJECTIVE: Critical organ shortages have resulted in ex vivo lung perfusion gaining clinical acceptance for lung evaluation and rehabilitation to expand the use of donation after circulatory death organs for lung transplantation. We hypothesized that an innovative use of airway pressure release ventilation during ex vivo lung perfusion improves lung function after transplantation. METHODS: Two groups (n = 4 animals/group) of porcine donation after circulatory death donor lungs were procured after hypoxic cardiac arrest and a 2-hour period of warm ischemia, followed by a 4-hour period of ex vivo lung perfusion rehabilitation with standard conventional volume-based ventilation or pressure-based airway pressure release ventilation...
January 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27737734/bronchodilator-inhalation-during-ex%C3%A2-vivo-lung-perfusion-improves-posttransplant-graft-function-after-warm-ischemia
#18
Kyoko Hijiya, Toyofumi F Chen-Yoshikawa, Takeshi Kondo, Hideki Motoyama, Akihiro Ohsumi, Daisuke Nakajima, Jin Sakamoto, Keiji Ohata, Mamoru Takahashi, Satona Tanaka, Ei Miyamoto, Akihiro Aoyama, Hiroshi Date
BACKGROUND: We hypothesized that an injured lung graft from donation after cardiac death donors could be reconditioned before transplantation using an ex vivo lung perfusion (EVLP) system and ventilation with high-dose short-acting β2-adrenergic receptor agonists. METHODS: Cardiac arrest was induced in a canine model by intravenous potassium chloride injection. Lungs were randomly assigned to two groups after 150 minutes of warm ischemia: inhalation of 1,400 μg of procaterol (BETA group, n = 5) or control group receiving solvent (CON group, n = 5) during EVLP...
October 10, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27728991/contemporary-review-of-the-organ-care-system-in-lung-transplantation-potential-advantages-of-a-portable-ex-vivo-lung-perfusion-system
#19
Bastian Schmack, Alexander Weymann, Prashant Mohite, Diana Garcia Saez, Bartlomiej Zych, Anton Sabashnikov, Mohamed Zeriouh, Joel Schamroth, Achim Koch, Simona Soresi, Olga Ananiadou, Fabio De Robertis, Matthias Karck, Andre Ruediger Simon, Aron Frederik Popov
Lung transplantation remains the definite treatment for various end-stage lung diseases. Cold flush perfusion, the standard method for organ procurement has severe limitations. Organ Care System (OCS; TransMedics, Inc., Andover, USA) is an approved method to preserve hearts for transplantation that allows for greatly reduced cold ischemic time. Consequently, the use of an adapted OCS lung as a portable full ex-vivo lung perfusion system in lung transplantation is currently under close evaluation. Areas covered: The aim of this article is to review the advantages and the role of the OCS in the field of lung transplantation by reviewing the latest literature and evaluating this novel procurement technique in the context of conventional methods like cold flush and regular ex-vivo lung perfusion...
November 2016: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27727070/correlation-between-pao2-fio2-and-airway-and-vascular-parameters-in-the-assessment-of-cellular-ex-vivo-lung-perfusion-system
#20
Toshihiro Okamoto, David Wheeler, Qiang Liu, Cristiano Quintini, J Steven Hata, Kenneth R McCurry
BACKGROUND: Ex vivo lung perfusion (EVLP) may be an essential process for the pre-transplant evaluation of the donor lungs. Currently, the partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2, or PF) ratio is the standard in the assessment of lung function in cellular EVLP, whereas other parameters, including airway and vascular parameters, have only been partially utilized. The primary purpose of this study is to assess the potential utility of other parameters as a surrogate of lung function in EVLP...
May 20, 2016: Journal of Heart and Lung Transplantation
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