Lung lavage and Surfactant Replacement During Ex Vivo Lung Perfusion for Treatment of Gastric Acid Aspiration-Induced Donor Lung Injury
Lung lavage and Surfactant Replacement During Ex Vivo Lung Perfusion for Treatment of Gastric Acid Aspiration-Induced Donor Lung Injury
复制标题
DOI：
10.1016/j.healun.2016.11.010
复制
发表时间：
2017-05-01
影响因子：
8.9
通讯作者：
Keshavjee, Shaf
中科院分区：
文献类型：
--
作者：
Nakajima, Daisuke;Liu, Mingyao;Keshavjee, Shaf
背景：离体肺灌注（EVLP）提供了在移植前治疗受损供体肺的机会。我们调查是否肺灌洗，以消除炎症抑制成分，其次是外源性表面活性物质替代，可以帮助肺恢复和改善移植后肺功能后胃吸入injuries.METHODS：胃酸吸入诱导供体猪，这是通气6小时，发展肺损伤。取出后冷保存10 h，行EVLP 6 h。将肺随机分为4组（每组n = 5）：（1）未处理（对照），（2）肺灌洗，（3）表面活性剂给药，和（4）肺灌洗，随后表面活性剂给药。再冷保存2 h后，左肺移植，再灌注4 h。结果：EVLP过程中给予表面活性物质后，生理肺功能明显改善。来自灌洗+表面活性剂组的EVLP灌注液显示白细胞介素（IL）-1 β、IL-6、IL-8和分泌型磷脂酶A的水平显著较低（2）。总磷脂酰胆碱增加，最小表面张力恢复到正常水平（
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. After retrieval and 10 hours of cold preservation, EVLP was performed for 6 hours. The lungs were randomly divided into 4 groups (n = 5, each): (1) no treatment (control), (2) lung lavage, (3) surfactant administration, and (4) lung lavage, followed by surfactant administration. After another 2-hour period of cold preservation, the left lung was transplanted and reperfused for 4 hours.RESULTS: Physiologic lung function significantly improved after surfactant administration during EVLP. The EVLP perfusate from the lavage + surfactant group showed significantly lower levels of interleukin (IL)-1 beta, IL-6, IL-8, and secretory phospholipase A(2). Total phosphatidylcholine was increased, and minimum surface tension was recovered to normal levels (