Frick Anna Elisabeth, Orlitová Michaela, Vanstapel Arno, Ordies Sofie, Claes Sandra, Schols Dominique, Heigl Tobias, Kaes Janne, Saez-Gimenez Berta, Vos Robin, Verleden Geert M, Vanaudenaerde Bart, Verleden Stijn E, Van Raemdonck Dirk E, Neyrinck Arne P
Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.
BREATHE, Department of Chronic Diseases, Metabolism and Ageing (Chrometa), Leuven Lung Transplant Unit, KU Leuven, Leuven, Belgium.
Intensive Care Med Exp. 2021 Feb 5;9(1):4. doi: 10.1186/s40635-021-00371-1.
Primary graft dysfunction (PGD) remains a major obstacle after lung transplantation. Ischemia-reperfusion injury is a known contributor to the development of PGD following lung transplantation. We developed a novel approach to assess the impact of increased pulmonary blood flow in a large porcine single-left lung transplantation model.
Twelve porcine left lung transplants were divided in two groups (n = 6, in low- (LF) and high-flow (HF) group). Donor lungs were stored for 24 h on ice, followed by left lung transplantation. In the HF group, recipient animals were observed for 6 h after reperfusion with partially clamping right pulmonary artery to achieve a higher flow (target flow 40-60% of total cardiac output) to the transplanted lung compared to the LF group, where the right pulmonary artery was not clamped.
Survival at 6 h was 100% in both groups. Histological, functional and biological assessment did not significantly differ between both groups during the first 6 h of reperfusion. injury was also present in the right native lung and showed signs compatible with the pathophysiological hallmarks of ischemia-reperfusion injury.
Partial clamping native pulmonary artery in large animal lung transplantation setting to study the impact of low versus high pulmonary flow on the development of ischemia reperfusion is feasible. In our study, differential blood flow had no effect on IRI. However, our findings might impact future studies with extracorporeal devices and represent a specific intra-operative problem during bilateral sequential single-lung transplantation.
原发性移植肺功能障碍（PGD）仍是肺移植后的主要障碍。缺血再灌注损伤是肺移植后PGD发生的已知因素。我们开发了一种新方法，以评估在大型猪单左肺移植模型中增加肺血流量的影响。
12例猪左肺移植分为两组（每组n = 6，低流量组（LF）和高流量组（HF））。供体肺在冰上保存24小时，然后进行左肺移植。在HF组中，再灌注后观察受体动物6小时，通过部分钳夹右肺动脉，使移植肺的血流量高于LF组（目标流量为心输出量的40-60%），LF组不钳夹右肺动脉。
两组6小时生存率均为100%。在再灌注的前6小时内，两组的组织学、功能和生物学评估无显著差异。右肺也出现损伤，并表现出与缺血再灌注损伤病理生理特征相符的迹象。
在大型动物肺移植中部分钳夹肺动脉，以研究低流量与高流量对缺血再灌注发展的影响是可行的。在我们的研究中，不同的血流量对缺血再灌注损伤没有影响。然而，我们的发现可能会影响未来体外装置的研究，并代表双侧序贯单肺移植术中的一个特定问题。
