Optimal Lung Inflation Techniques in a Rat Lung Transplantation Model: A Revisit

Yugo Tanaka; Norihisa Shigemura; Kentaro Noda; Tomohiro Kawamura; Kumiko Isse; Donna B. Stolz; Christian A. Bermudez

doi:10.1055/s-0034-1373902

The Thoracic and Cardiovascular Surgeon, Table of Contents

Thorac Cardiovasc Surg 2014; 62(05): 427-433
DOI: 10.1055/s-0034-1373902

Original Thoracic

Georg Thieme Verlag KG Stuttgart · New York

Optimal Lung Inflation Techniques in a Rat Lung Transplantation Model: A Revisit

Authors

Yugo Tanaka

¹Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States

²Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Japan
Norihisa Shigemura

¹Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
Kentaro Noda

¹Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
Tomohiro Kawamura

¹Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
Kumiko Isse

³Division of Transplantation and Thomas E. Starzl Transplantation Institute, Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
Donna B. Stolz

⁴Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
Christian A. Bermudez

¹Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States

Abstract

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Abstract

Background Most of the experimental work assessing optimal lung inflation during lung graft preservation was performed in the late 1990s. Since that time, lung preservation before transplantation has been more standardized, and the optimal lung inflation techniques used during lung preservation in the current clinical setting remain undefined. Nonetheless, lung inflation during storage may play a pivotal role in optimal lung preservation.

Materials and Methods Lewis rat lungs were perfused with and stored in cold, low-potassium dextran solution (Perfadex, Vitrolife, Göteborg, Sweden) for 6 hours at different levels of lung inflation (25, 50, 75, or 100% of vital capacity [VC]). Orthotopic left lung transplantation using cuff techniques was performed in syngeneic Lewis rats. Posttransplant allograft function, expression of proinflammatory mediators, and expression of lung surfactants were evaluated.

Results Lungs inflated to 75 or 100% VC showed a significantly better oxygenation in blood gas analysis than lungs inflated to 25 or 50% VC. The levels of mRNAs for tumor necrosis factor-α, pro-interleukin-1β, intracellular adhesion molecule 1 were attenuated in lungs inflated to 75 or 100% VC as compared with deflated lungs, suggesting reduced ischemia/reperfusion injury. In addition, transmission electron microscopy demonstrated better preserved lung surfactants in the alveolar space in the lungs inflated to 75 or 100% VC.

Conclusions Inflating lungs to 75 or 100% VC during preservation may be beneficial and result in better posttransplant allograft function through attenuated reperfusion injury and better preserved lung surfactants.

Keywords

organ preservation - transplantation - lung - ischemia/reperfusion

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References

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