Do we need to cool the lung graft after ex vivo lung perfusion? A preliminary study

Alessia Stanzi, Arne Neyrinck, Jana Somers, Hans Cauwenberghs, Eric Verbeken, Luigi Santambrogio, Dirk Van Raemdonck

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: After normothermic ex vivo lung perfusion (EVLP), pulmonary grafts are usually flush-cooled and stored on ice until implantation although evidence for this practice lacks. We compared outcomes between 2 post-EVLP preservation strategies in a porcine left single-lung transplantation model. Material and methods: After cold flush and 2-h EVLP, donor lungs were prepared and split. In [C], (n = 5) lungs cooled on device to 15°C were preserved in ice-water; in [W] (n = 5), lungs were disconnected from EVLP at 37°C and kept at room temperature. The left lung was transplanted in a recipient animal. Posttransplant, 6 h-monitoring included hourly assessment of pulmonary vascular resistance, pulmonary artery pressure, plateau airway pressure, compliance, and oxygenation before and after exclusion of the right lung. Lung biopsies and bronchoscopy with bronchoalveolar lavage (BAL) were performed at retrieval, at the end of EVLP (R lung), and 1 and 6 h after reperfusion (L lung). Results: Lungs in [W] showed the highest compliance (P <0.05) and the lowest plateau airway pressure (not statistically significant) throughout the whole reperfusion period. Oxygenation and pulmonary artery pressure were similar between groups. Pulmonary vascular resistance was stable in [C], but rose after reperfusion in [W]. Histologic signs of lung injury and BAL neutrophilia were more pronounced in [C] at 1 h (not statistically significant and P <0.05, respectively). BAL cytokine levels and lung tissue expression of intercellular adhesion molecule 1 did not differ between groups. Conclusions: Normothermic preparation after EVLP results in similar graft performances compared with lung cooling after EVLP.

Original languageEnglish
Pages (from-to)647-655
Number of pages9
JournalJournal of Surgical Research
Volume192
Issue number2
DOIs
Publication statusPublished - Dec 1 2014

Fingerprint

Perfusion
Transplants
Lung
Bronchoalveolar Lavage
Reperfusion
Pressure
Ice
Vascular Resistance
Pulmonary Artery
Compliance
Lung Transplantation
Lung Injury
Bronchoscopy
Intercellular Adhesion Molecule-1
Swine

Keywords

  • Ex vivo lung perfusion
  • Flush
  • Lung transplantation
  • Temperature

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

Stanzi, A., Neyrinck, A., Somers, J., Cauwenberghs, H., Verbeken, E., Santambrogio, L., & Van Raemdonck, D. (2014). Do we need to cool the lung graft after ex vivo lung perfusion? A preliminary study. Journal of Surgical Research, 192(2), 647-655. https://doi.org/10.1016/j.jss.2014.07.068

Do we need to cool the lung graft after ex vivo lung perfusion? A preliminary study. / Stanzi, Alessia; Neyrinck, Arne; Somers, Jana; Cauwenberghs, Hans; Verbeken, Eric; Santambrogio, Luigi; Van Raemdonck, Dirk.

In: Journal of Surgical Research, Vol. 192, No. 2, 01.12.2014, p. 647-655.

Research output: Contribution to journalArticle

Stanzi, A, Neyrinck, A, Somers, J, Cauwenberghs, H, Verbeken, E, Santambrogio, L & Van Raemdonck, D 2014, 'Do we need to cool the lung graft after ex vivo lung perfusion? A preliminary study', Journal of Surgical Research, vol. 192, no. 2, pp. 647-655. https://doi.org/10.1016/j.jss.2014.07.068
Stanzi, Alessia ; Neyrinck, Arne ; Somers, Jana ; Cauwenberghs, Hans ; Verbeken, Eric ; Santambrogio, Luigi ; Van Raemdonck, Dirk. / Do we need to cool the lung graft after ex vivo lung perfusion? A preliminary study. In: Journal of Surgical Research. 2014 ; Vol. 192, No. 2. pp. 647-655.
@article{c767b598de3947baabd42078c2451620,
title = "Do we need to cool the lung graft after ex vivo lung perfusion? A preliminary study",
abstract = "Background: After normothermic ex vivo lung perfusion (EVLP), pulmonary grafts are usually flush-cooled and stored on ice until implantation although evidence for this practice lacks. We compared outcomes between 2 post-EVLP preservation strategies in a porcine left single-lung transplantation model. Material and methods: After cold flush and 2-h EVLP, donor lungs were prepared and split. In [C], (n = 5) lungs cooled on device to 15°C were preserved in ice-water; in [W] (n = 5), lungs were disconnected from EVLP at 37°C and kept at room temperature. The left lung was transplanted in a recipient animal. Posttransplant, 6 h-monitoring included hourly assessment of pulmonary vascular resistance, pulmonary artery pressure, plateau airway pressure, compliance, and oxygenation before and after exclusion of the right lung. Lung biopsies and bronchoscopy with bronchoalveolar lavage (BAL) were performed at retrieval, at the end of EVLP (R lung), and 1 and 6 h after reperfusion (L lung). Results: Lungs in [W] showed the highest compliance (P <0.05) and the lowest plateau airway pressure (not statistically significant) throughout the whole reperfusion period. Oxygenation and pulmonary artery pressure were similar between groups. Pulmonary vascular resistance was stable in [C], but rose after reperfusion in [W]. Histologic signs of lung injury and BAL neutrophilia were more pronounced in [C] at 1 h (not statistically significant and P <0.05, respectively). BAL cytokine levels and lung tissue expression of intercellular adhesion molecule 1 did not differ between groups. Conclusions: Normothermic preparation after EVLP results in similar graft performances compared with lung cooling after EVLP.",
keywords = "Ex vivo lung perfusion, Flush, Lung transplantation, Temperature",
author = "Alessia Stanzi and Arne Neyrinck and Jana Somers and Hans Cauwenberghs and Eric Verbeken and Luigi Santambrogio and {Van Raemdonck}, Dirk",
year = "2014",
month = "12",
day = "1",
doi = "10.1016/j.jss.2014.07.068",
language = "English",
volume = "192",
pages = "647--655",
journal = "Journal of Surgical Research",
issn = "0022-4804",
publisher = "Academic Press Inc.",
number = "2",

}

TY - JOUR

T1 - Do we need to cool the lung graft after ex vivo lung perfusion? A preliminary study

AU - Stanzi, Alessia

AU - Neyrinck, Arne

AU - Somers, Jana

AU - Cauwenberghs, Hans

AU - Verbeken, Eric

AU - Santambrogio, Luigi

AU - Van Raemdonck, Dirk

PY - 2014/12/1

Y1 - 2014/12/1

N2 - Background: After normothermic ex vivo lung perfusion (EVLP), pulmonary grafts are usually flush-cooled and stored on ice until implantation although evidence for this practice lacks. We compared outcomes between 2 post-EVLP preservation strategies in a porcine left single-lung transplantation model. Material and methods: After cold flush and 2-h EVLP, donor lungs were prepared and split. In [C], (n = 5) lungs cooled on device to 15°C were preserved in ice-water; in [W] (n = 5), lungs were disconnected from EVLP at 37°C and kept at room temperature. The left lung was transplanted in a recipient animal. Posttransplant, 6 h-monitoring included hourly assessment of pulmonary vascular resistance, pulmonary artery pressure, plateau airway pressure, compliance, and oxygenation before and after exclusion of the right lung. Lung biopsies and bronchoscopy with bronchoalveolar lavage (BAL) were performed at retrieval, at the end of EVLP (R lung), and 1 and 6 h after reperfusion (L lung). Results: Lungs in [W] showed the highest compliance (P <0.05) and the lowest plateau airway pressure (not statistically significant) throughout the whole reperfusion period. Oxygenation and pulmonary artery pressure were similar between groups. Pulmonary vascular resistance was stable in [C], but rose after reperfusion in [W]. Histologic signs of lung injury and BAL neutrophilia were more pronounced in [C] at 1 h (not statistically significant and P <0.05, respectively). BAL cytokine levels and lung tissue expression of intercellular adhesion molecule 1 did not differ between groups. Conclusions: Normothermic preparation after EVLP results in similar graft performances compared with lung cooling after EVLP.

AB - Background: After normothermic ex vivo lung perfusion (EVLP), pulmonary grafts are usually flush-cooled and stored on ice until implantation although evidence for this practice lacks. We compared outcomes between 2 post-EVLP preservation strategies in a porcine left single-lung transplantation model. Material and methods: After cold flush and 2-h EVLP, donor lungs were prepared and split. In [C], (n = 5) lungs cooled on device to 15°C were preserved in ice-water; in [W] (n = 5), lungs were disconnected from EVLP at 37°C and kept at room temperature. The left lung was transplanted in a recipient animal. Posttransplant, 6 h-monitoring included hourly assessment of pulmonary vascular resistance, pulmonary artery pressure, plateau airway pressure, compliance, and oxygenation before and after exclusion of the right lung. Lung biopsies and bronchoscopy with bronchoalveolar lavage (BAL) were performed at retrieval, at the end of EVLP (R lung), and 1 and 6 h after reperfusion (L lung). Results: Lungs in [W] showed the highest compliance (P <0.05) and the lowest plateau airway pressure (not statistically significant) throughout the whole reperfusion period. Oxygenation and pulmonary artery pressure were similar between groups. Pulmonary vascular resistance was stable in [C], but rose after reperfusion in [W]. Histologic signs of lung injury and BAL neutrophilia were more pronounced in [C] at 1 h (not statistically significant and P <0.05, respectively). BAL cytokine levels and lung tissue expression of intercellular adhesion molecule 1 did not differ between groups. Conclusions: Normothermic preparation after EVLP results in similar graft performances compared with lung cooling after EVLP.

KW - Ex vivo lung perfusion

KW - Flush

KW - Lung transplantation

KW - Temperature

UR - http://www.scopus.com/inward/record.url?scp=84912106910&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84912106910&partnerID=8YFLogxK

U2 - 10.1016/j.jss.2014.07.068

DO - 10.1016/j.jss.2014.07.068

M3 - Article

C2 - 25201574

AN - SCOPUS:84912106910

VL - 192

SP - 647

EP - 655

JO - Journal of Surgical Research

JF - Journal of Surgical Research

SN - 0022-4804

IS - 2

ER -