Negative pressure ventilation decreases inflammation and lung edema during normothermic ex-vivo lung perfusion

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
Nader S AboelnazarJayan Nagendran

Abstract

Normothermic ex-vivo lung perfusion (EVLP) using positive pressure ventilation (PPV) and both acellular and red blood cell (RBC)-based perfusate solutions have increased the rate of donor organ utilization. We sought to determine whether a negative pressure ventilation (NPV) strategy would improve donor lung assessment during EVLP. Thirty-two pig lungs were perfused ex vivo for 12 hours in a normothermic state, and were allocated equally to 4 groups according to the mode of ventilation (positive pressure ventilation [PPV] vs NPV) and perfusate composition (acellular vs RBC). The impact of ventilation strategy on the preservation of 6 unutilized human donor lungs was also evaluated. Physiologic parameters, cytokine profiles, lung injury, bullae and edema formation were compared between treatment groups. Perfused lungs demonstrated acceptable oxygenation (partial pressure of arterial oxygen/fraction of inspired oxygen ratio >350 mm Hg) and physiologic parameters. However, there was less generation of pro-inflammatory cytokines (tumor necrosis factor-α, interleukin-6 and interleukin-8) in human and pig lungs perfused, irrespective of perfusate solution used, when comparing NPV with PPV (p < 0.05), and a reduction in bullae formati...Continue Reading

Citations

Sep 20, 2018·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Peter DromparisBenjamin A Adam
Aug 20, 2019·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Max T BuchkoJayan Nagendran
Nov 7, 2019·Current Opinion in Anaesthesiology·Jacobo Moreno Garijo, Andrew Roscoe
Apr 19, 2020·Current Opinion in Organ Transplantation·Jenny GilmourAndrew J Fisher
May 2, 2020·Cell and Tissue Research·Reinhard Pabst
Jun 2, 2020·Journal of Anesthesia·Zhaosheng JinDaqing Ma
May 15, 2020·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Christopher M BobbaBryan A Whitson
Mar 24, 2020·The Journal of Thoracic and Cardiovascular Surgery·Ilker IskenderIlhan Inci
Jul 16, 2019·Transplantation Proceedings·Max T BuchkoJayan Nagendran
Oct 13, 2020·Transplantation·Nikhil K PrasadChristine L Lau
Jul 2, 2021·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Arpad HasenauerLucas Liaudet
Sep 24, 2021·Journal of Applied Physiology·Micha Sam Brickman RaredonLaura E Niklason

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