Department of Cardiothoracic Surgery and Transplantation, Skåne University Hospital, Lund, Sweden.
Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden.
Nat Commun. 2022 Jul 26;13(1):4173. doi: 10.1038/s41467-022-31811-5.
Despite improvements, lung transplantation remains hampered by both a scarcity of donor organs and by mortality following primary graft dysfunction (PGD). Since acute respiratory distress syndrome (ARDS) limits donor lungs utilization, we investigated cytokine adsorption as a means of treating ARDS donor lungs. We induced mild to moderate ARDS using lipopolysaccharide in 16 donor pigs. Lungs were then treated with or without cytokine adsorption during ex vivo lung perfusion (EVLP) and/or post-transplantation using extracorporeal hemoperfusion. The treatment significantly decreased cytokine levels during EVLP and decreased levels of immune cells post-transplantation. Histology demonstrated fewer signs of lung injury across both treatment periods and the incidence of PGD was significantly reduced among treated animals. Overall, cytokine adsorption was able to restore lung function and reduce PGD in lung transplantation. We suggest this treatment will increase the availability of donor lungs and increase the tolerability of donor lungs in the recipient.
尽管有所改善，但肺移植仍然受到供体器官短缺和原发性移植物功能障碍（PGD）后死亡率的限制。由于急性呼吸窘迫综合征（ARDS）限制了供体肺的使用，我们研究了细胞因子吸附作为治疗 ARDS 供体肺的一种方法。我们使用脂多糖在 16 只供体猪中诱导轻度至中度 ARDS。然后在体外肺灌注（EVLP）期间和/或移植后使用体外血液灌流对肺进行细胞因子吸附治疗。该治疗在 EVLP 过程中显著降低了细胞因子水平，并降低了移植后免疫细胞的水平。组织学显示在两个治疗期内肺损伤的迹象都更少，并且治疗动物的 PGD 发生率显著降低。总的来说，细胞因子吸附能够恢复肺功能并降低肺移植中的 PGD。我们认为这种治疗方法将增加供体肺的可用性，并提高受体对供体肺的耐受性。
