Department of Biomedical Engineering, Columbia University Medical Center, Columbia University, New York, NY, 10032, USA.
Department of Surgery, Columbia University Medical Center, Columbia University, New York, NY, 10032, USA.
Nat Commun. 2019 May 7;10(1):1985. doi: 10.1038/s41467-019-09908-1.
The number of available donor organs limits lung transplantation, the only lifesaving therapy for the increasing population of patients with end-stage lung disease. A prevalent etiology of injury that renders lungs unacceptable for transplantation is gastric aspiration, a deleterious insult to the pulmonary epithelium. Currently, severely damaged donor lungs cannot be salvaged with existing devices or methods. Here we report the regeneration of severely damaged lungs repaired to meet transplantation criteria by utilizing an interventional cross-circulation platform in a clinically relevant swine model of gastric aspiration injury. Enabled by cross-circulation with a living swine, prolonged extracorporeal support of damaged lungs results in significant improvements in lung function, cellular regeneration, and the development of diagnostic tools for non-invasive organ evaluation and repair. We therefore propose that the use of an interventional cross-circulation platform could enable recovery of otherwise unsalvageable lungs and thus expand the donor organ pool.
可供使用的捐赠器官数量限制了肺移植的发展,而肺移植是治疗终末期肺部疾病患者的唯一救生疗法。导致肺脏不能接受移植的常见损伤病因是胃吸入,这对肺上皮细胞是一种有害的损伤。目前,现有的设备或方法无法挽救严重受损的供体肺脏。在这里,我们报告了在临床相关的猪胃吸入损伤模型中,利用介入性交叉循环平台,对严重受损的肺脏进行修复,使其达到移植标准并实现再生的情况。通过与活体猪进行交叉循环,对受损肺脏进行长时间的体外支持,可显著改善肺功能、细胞再生,并开发出用于非侵入性器官评估和修复的诊断工具。因此,我们提出使用介入性交叉循环平台可以恢复原本无法挽救的肺脏,从而扩大供体器官库。