El-Andari Ryaan, Kang Jimmy J H, Fialka Nicholas M, Weatherald Jason, Alavi Parnian, Jahroudi Nadia, Freed Darren H, Nagendran Jayan
Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada.
Division of Pulmonary Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Transplant Direct. 2025 Aug 22;11(9):e1855. doi: 10.1097/TXD.0000000000001855. eCollection 2025 Sep.
Ischemia/reperfusion injury after lung transplantation is a significant cause of morbidity. In the realm of ex vivo lung perfusion (EVLP), inflammation, edema formation, and reduced compliance have limited the durability of EVLP. Previous evidence has suggested that platelet activation and thrombosis may play a role in both conditions.
A literature search of PubMed and Embase was conducted, including all articles describing all human or animal investigations of platelet activation or the use of antiplatelet agents in the settings of EVLP or lung transplantation. Articles published from database inception to July 15, 2024, were analyzed.
In total, 9 studies were included in the review. Studies on EVLP have found an association between platelet activation and adverse effects on lung function, whereas in lung transplantation, platelet activation appears to play a role in primary graft dysfunction. In both settings, the inhibition of platelets ameliorated these effects.
Platelet activation in EVLP and lung transplantation results in distal arterial thrombosis and has been associated with graft dysfunction. The use of antiplatelet agents in the included studies was associated with reduced lung injury and improved lung function on EVLP or during lung transplantation.
肺移植后的缺血/再灌注损伤是发病的重要原因。在体外肺灌注（EVLP）领域，炎症、水肿形成和顺应性降低限制了EVLP的持续时间。先前的证据表明，血小板活化和血栓形成可能在这两种情况中都起作用。
对PubMed和Embase进行文献检索，包括所有描述在EVLP或肺移植背景下血小板活化或使用抗血小板药物的所有人类或动物研究的文章。分析了从数据库建立到2024年7月15日发表的文章。
该综述共纳入9项研究。关于EVLP的研究发现血小板活化与对肺功能的不良影响之间存在关联，而在肺移植中，血小板活化似乎在原发性移植功能障碍中起作用。在这两种情况下，抑制血小板均可改善这些影响。
EVLP和肺移植中的血小板活化会导致远端动脉血栓形成，并与移植功能障碍有关。在纳入的研究中，使用抗血小板药物与减少肺损伤以及改善EVLP期间或肺移植期间的肺功能有关。
