An extracellular oxygen carrier during prolonged pulmonary preservation improves post-transplant lung function
An extracellular oxygen carrier during prolonged pulmonary preservation improves post-transplant lung function
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DOI：
10.1016/j.healun.2020.03.027
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发表时间：
2020-06-01
影响因子：
8.9
通讯作者：
Cypel, Marcelo
中科院分区：
文献类型：
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作者：
Ali, Aadil;Watanabe, Yui;Cypel, Marcelo
背景：使用一种新的细胞外氧载体（EOC）保存添加剂，称为HEMO(2)Life，最近被证明可以更好地保存不同类型的实体器官。本研究旨在探讨其延长肺保存时间的作用及其作用机制。方法：将供猪随机分为2组（每组6头）：(1)低温保存36 h或(2)低温保存36 h，添加1 g/l的EOC。通过12小时恒温离体肺灌注（EVLP），然后将左单肺移植到受体猪中，对肺进行评估。移植物再灌注4小时，随后右肺动脉夹紧评估移植物氧合功能。结果：在EVLP评估中，经eoc处理的肺的生理参数有所改善，而对照肺则恶化。在共保存48小时（36小时冷置+ 12小时常温EVLP）后，治疗组移植移植物的氧合性明显优于对照组（PaO2/FiO(2): 437 +/- 36 mm Hg vs 343 +/- 27 mm Hg, p = 0.041）。此外，与未使用EOC的对照组相比，使用EOC可显著减少水肿形成（湿干比：4.95 +/- 0.29 vs 6.05 +/- 0.33, p = 0.026），减少凋亡细胞死亡（p = 0.041），改善紧密连接保存（p = 0.002），并且移植后受体血浆中循环IL-6水平较低（p = 0.004）。结论：在延长肺保存期期间使用EOC可显著改善移植后早期肺功能。(C) 2020国际心肺移植学会。版权所有。
BACKGROUND: The use of a novel extracellular oxygen carrier (EOC) preservation additive known as HEMO(2)Life has recently been shown to lead to a superior preservation of different types of solid organs. Our study aimed to investigate the effect of this EOC on extending lung preservation time and its mechanism of action.METHODS: Donor pigs were randomly allocated to either of the following 2 groups (n = 6 per group): (1) 36 hours cold preservation or (2) 36 hours cold preservation with 1 g/liter of EOC. The lungs were evaluated through 12 hours of normothermic ex vivo lung perfusion (EVLP) followed by a left-single lung transplant into a recipient pig. Grafts were reperfused for 4 hours, followed by right pulmonary artery clamping to assess graft oxygenation function.RESULTS: During EVLP assessment, EOC-treated lungs showed improvements in physiologic parameters, whereas the control lungs deteriorated. After a total of 48 hours of preservation (36 hours cold + 12 hours normothermic EVLP), transplanted grafts in the treatment group displayed significantly better oxygenation than in the controls (PaO2/FiO(2): 437 +/- 36 mm Hg vs 343 +/- 27 mm Hg, p = 0.041). In addition, the use of EOC led to significantly less edema formation (wet-to-dry ratio: 4.95 +/- 0.29 vs 6.05 +/- 0.33, p = 0.026), less apoptotic cell death (p = 0.041), improved tight junction preservation (p = 0.002), and lower levels of circulating IL-6 within recipient plasma (p = 0.004) compared with non-use of EOC in the control group after transplantation.CONCLUSION: The use of an EOC during an extended pulmonary preservation period led to significantly superior early post-transplant lung function. (C) 2020 International Society for Heart and Lung Transplantation. All rights reserved.