Cargando…

Lungs exposed to 1 hour warm ischemia without heparin before harvesting might be suitable candidates for transplantation

BACKGROUND: The limiting factor for lung transplantation is the lack of donor organs. The usage of lungs from donation after cardiac death (DCD) would dramatically increase donor availability. In the present paper we wanted to investigate lungs exposed to 1 h of warm ischemia without heparin followe...

Descripción completa

Detalles Bibliográficos
Autores principales: Liersch-Nordqvist, Annika, Ingemansson, Richard, Pierre, Leif, Hlebowicz, Joanna, Lindstedt, Sandra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4619285/
https://www.ncbi.nlm.nih.gov/pubmed/26500001
http://dx.doi.org/10.1186/s13019-015-0339-1
_version_ 1782397066992943104
author Liersch-Nordqvist, Annika
Ingemansson, Richard
Pierre, Leif
Hlebowicz, Joanna
Lindstedt, Sandra
author_facet Liersch-Nordqvist, Annika
Ingemansson, Richard
Pierre, Leif
Hlebowicz, Joanna
Lindstedt, Sandra
author_sort Liersch-Nordqvist, Annika
collection PubMed
description BACKGROUND: The limiting factor for lung transplantation is the lack of donor organs. The usage of lungs from donation after cardiac death (DCD) would dramatically increase donor availability. In the present paper we wanted to investigate lungs exposed to 1 h of warm ischemia without heparin followed by flush-perfusion and cold storage compared to lungs harvested from heart beating donors (HBD) using standard harvesting technique. METHODS: Twelve Swedish domestic pigs were randomized into two groups. Six pigs (DCD group) underwent ventricular fibrillation and were then left untouched for 1 h after declaration of death. They did not receive heparin. The lungs were then harvested and flush-perfused with Perfadex® solution and the organs were stored at 8 °C for 4 h. Six pigs (HBD group) received heparin and the lungs were harvested and flush-perfused with Perfadex® solution and the organs were stored at 8 °C for 4 h. Lung function was evaluated, using ex vivo lung perfusion (EVLP), with blood gases at different oxygen levels, pulmonary vascular resistance (PVR), lung weight, and macroscopic appearance. RESULTS: At FiO(2) 1.0, the PaO(2) in the DCD group was 51.7 ± 2.0 kPa and in the HBD group 68.6 ± 2.4 kPa (p < 0.01). Significantly lower PVR levels were measured in the DCD group (372 ± 31 dyne x s/cm(5)) compared to the HBD group (655 ± 45 dyne x s/cm(5)) (p < 0.001). There was no significant difference between groups in weight, compliance or signs of pulmonary thrombosis or embolization. CONCLUSIONS: It seems as if DCD lungs exposed to 1 h of warm ischemia before 4 h of cold storage has satisfying oxygenation capacity, low PVR, normal weight and no signs of thrombosis or embolization. According to our study it seems as lungs exposed to 1 h warm ischemia without heparin might be good candidates for transplantation.
format Online
Article
Text
id pubmed-4619285
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-46192852015-10-26 Lungs exposed to 1 hour warm ischemia without heparin before harvesting might be suitable candidates for transplantation Liersch-Nordqvist, Annika Ingemansson, Richard Pierre, Leif Hlebowicz, Joanna Lindstedt, Sandra J Cardiothorac Surg Research Article BACKGROUND: The limiting factor for lung transplantation is the lack of donor organs. The usage of lungs from donation after cardiac death (DCD) would dramatically increase donor availability. In the present paper we wanted to investigate lungs exposed to 1 h of warm ischemia without heparin followed by flush-perfusion and cold storage compared to lungs harvested from heart beating donors (HBD) using standard harvesting technique. METHODS: Twelve Swedish domestic pigs were randomized into two groups. Six pigs (DCD group) underwent ventricular fibrillation and were then left untouched for 1 h after declaration of death. They did not receive heparin. The lungs were then harvested and flush-perfused with Perfadex® solution and the organs were stored at 8 °C for 4 h. Six pigs (HBD group) received heparin and the lungs were harvested and flush-perfused with Perfadex® solution and the organs were stored at 8 °C for 4 h. Lung function was evaluated, using ex vivo lung perfusion (EVLP), with blood gases at different oxygen levels, pulmonary vascular resistance (PVR), lung weight, and macroscopic appearance. RESULTS: At FiO(2) 1.0, the PaO(2) in the DCD group was 51.7 ± 2.0 kPa and in the HBD group 68.6 ± 2.4 kPa (p < 0.01). Significantly lower PVR levels were measured in the DCD group (372 ± 31 dyne x s/cm(5)) compared to the HBD group (655 ± 45 dyne x s/cm(5)) (p < 0.001). There was no significant difference between groups in weight, compliance or signs of pulmonary thrombosis or embolization. CONCLUSIONS: It seems as if DCD lungs exposed to 1 h of warm ischemia before 4 h of cold storage has satisfying oxygenation capacity, low PVR, normal weight and no signs of thrombosis or embolization. According to our study it seems as lungs exposed to 1 h warm ischemia without heparin might be good candidates for transplantation. BioMed Central 2015-10-23 /pmc/articles/PMC4619285/ /pubmed/26500001 http://dx.doi.org/10.1186/s13019-015-0339-1 Text en © Liersch-Nordqvist et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Liersch-Nordqvist, Annika
Ingemansson, Richard
Pierre, Leif
Hlebowicz, Joanna
Lindstedt, Sandra
Lungs exposed to 1 hour warm ischemia without heparin before harvesting might be suitable candidates for transplantation
title Lungs exposed to 1 hour warm ischemia without heparin before harvesting might be suitable candidates for transplantation
title_full Lungs exposed to 1 hour warm ischemia without heparin before harvesting might be suitable candidates for transplantation
title_fullStr Lungs exposed to 1 hour warm ischemia without heparin before harvesting might be suitable candidates for transplantation
title_full_unstemmed Lungs exposed to 1 hour warm ischemia without heparin before harvesting might be suitable candidates for transplantation
title_short Lungs exposed to 1 hour warm ischemia without heparin before harvesting might be suitable candidates for transplantation
title_sort lungs exposed to 1 hour warm ischemia without heparin before harvesting might be suitable candidates for transplantation
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4619285/
https://www.ncbi.nlm.nih.gov/pubmed/26500001
http://dx.doi.org/10.1186/s13019-015-0339-1
work_keys_str_mv AT lierschnordqvistannika lungsexposedto1hourwarmischemiawithoutheparinbeforeharvestingmightbesuitablecandidatesfortransplantation
AT ingemanssonrichard lungsexposedto1hourwarmischemiawithoutheparinbeforeharvestingmightbesuitablecandidatesfortransplantation
AT pierreleif lungsexposedto1hourwarmischemiawithoutheparinbeforeharvestingmightbesuitablecandidatesfortransplantation
AT hlebowiczjoanna lungsexposedto1hourwarmischemiawithoutheparinbeforeharvestingmightbesuitablecandidatesfortransplantation
AT lindstedtsandra lungsexposedto1hourwarmischemiawithoutheparinbeforeharvestingmightbesuitablecandidatesfortransplantation