Bronchodilator Inhalation During Ex Vivo Lung Perfusion Improves Posttransplant Graft Function After Warm Ischemia

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• 作者：Kyoko Hijiya ; MD ; Toyofumi F. Chen-Yoshikawa ; MD ; PhD ; Takeshi Kondo ; MD ; PhD ; Hideki Motoyama ; MD ; PhD ; Akihiro Ohsumi ; MD ; Daisuke Nakajima ; MD ; Jin Sakamoto ; MD ; PhD ; Keiji Ohata ; MD ; Mamoru Takahashi ; MD ; Satona Tanaka ; MD ; Ei Miyamoto ; MD ; Akihiro Aoyama ; MD ; PhD ; Hiroshi Date ; MD ; PhD ; ^{hdate@kuhp.kyoto-u.ac.jp}
• 刊名：The Annals of Thoracic Surgery
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：103
• 期：2
• 页码：447-453
• 全文大小：1351 K
• 卷排序：103

文摘

We hypothesized that an injured lung graft from donation after cardiac death donors could be reconditioned before transplantation using an ex vivo lung perfusion (EVLP) system and ventilation with high-dose short-acting β2-adrenergic receptor agonists.MethodsCardiac arrest was induced in a canine model by intravenous potassium chloride injection. Lungs were randomly assigned to two groups after 150 minutes of warm ischemia: inhalation of 1,400 μg of procaterol (BETA group, n = 5) or control group receiving solvent (CON group, n = 5) during EVLP. Left lungs were transplanted after 120 minutes of EVLP. Functional variables, tissue adenosine 5′-triphosphate levels, and tissue cyclic adenosine monophosphate levels were measured 240 minutes after transplantation.ResultsPhysiologic pulmonary function was similar at the end of EVLP in both groups. However, significantly better graft oxygenation, dynamic pulmonary compliance, and reduced pulmonary vascular resistance were observed in the BETA group than in the CON group 240 minutes after transplantation. No severe adverse effects were observed after lung transplantation in the BETA group. Lung tissue adenosine 5′-triphosphate levels and cyclic adenosine monophosphate levels were significantly higher in the BETA group than in the CON group at the end of EVLP and at 240 minutes after transplantation.ConclusionsHigh-dose nebulized procaterol during EVLP ameliorated lung graft dysfunction at the early posttransplantation period without severe adverse effects. These data suggest that lung reconditioning with procaterol ventilation during EVLP improves lung graft function after transplantation.