China-Japan Friendship Institute of Clinical Medicine; Department of Thoracic Surgery, China-Japan Friendship Hospital.
Department of Thoracic Surgery, China-Japan Friendship Hospital.
J Vis Exp. 2024 Oct 18(212). doi: 10.3791/67168.
The increasing scarcity of donor lungs for transplantation has spurred significant interest in the utilization of organs procured from donors after cardiac death (DCD). However, a critical challenge remains in maximizing the number of viable lungs that meet stringent criteria for clinical use. Ex vivo lung perfusion (EVLP) emerges as a promising technology to evaluate and potentially improve the function of donated lungs. This paper describes the development of a cost-effective and reproducible small animal experimental platform specifically designed for EVLP research. This platform offers a high degree of customization, enabling researchers to tailor experimental parameters to address specific research questions within the field of EVLP. The team established a rat model to simulate DCD and implemented a two-stage preservation approach. Lungs were subjected to static cold storage using a perfusate solution at 4 °C for 4 h, followed by normothermic EVLP for another 4 h. Researchers evaluated various lung function parameters, including pulmonary vascular resistance, pulmonary dynamic compliance, blood gas measurements of the perfusate, and apoptotic cell death in lung tissues. The study demonstrates that EVLP could significantly improve the functional performance of DCD lungs compared to simple cold storage at 4 °C, suggesting that EVLP has the potential to mitigate ischemia-reperfusion injury and enhance graft function following circulatory death, thereby increasing the pool of transplantable lungs.
供体肺的日益短缺促使人们对利用心脏死亡供体(DCD)获取的器官产生了浓厚兴趣。然而,如何最大限度地增加符合严格临床使用标准的可用肺数量仍然是一个关键挑战。离体肺灌注(EVLP)作为一种评估和潜在改善供肺功能的有前途的技术应运而生。本文描述了一种经济高效且可重复的小动物实验平台的开发,该平台专门用于 EVLP 研究。该平台具有高度的可定制性,使研究人员能够根据 EVLP 领域的具体研究问题调整实验参数。该团队建立了一个大鼠模型来模拟 DCD,并采用两阶段保存方法。肺在 4°C 的灌流液中进行 4 小时的静态冷保存,然后进行 4 小时的常温 EVLP。研究人员评估了各种肺功能参数,包括肺血管阻力、肺动态顺应性、灌流液血气测量值以及肺组织中的细胞凋亡。研究表明,与简单的 4°C 冷保存相比,EVLP 可以显著改善 DCD 肺的功能性能,这表明 EVLP 有可能减轻缺血再灌注损伤并增强循环死亡后移植物的功能,从而增加可移植肺的数量。