1
|
Luna-Flores A, Olmos-Zuñiga JR, Jasso-Victoria R, Gaxiola-Gaxiola M, Aguirre-Pérez T, Ruiz V, García-Torrentera R, Silva-Martínez M, Zenteno E, Gutierrez-Ospina G, Santillan-Doherty P. Expression of Claudin-4 in Lung Ischemia-Reperfusion Injury in Experimental Lung Transplantation. J INVEST SURG 2020; 35:191-200. [PMID: 32900258 DOI: 10.1080/08941939.2020.1815253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess the presence of CLDN4 in bronchoalveolar lavage fluid (BALF) and pulmonary tissue as an early indicator of LIRI and its relationship with changes in pulmonary physiology, edema formation and histology in an experimental porcine model of LTx with CIT of 50 min or 6 h. METHODS In 12 pigs, LIRI was produced by: group I (n = 6) LTx with 50 min of CIT (LTx-50 min-CIT); and group II (n = 6) LTx with 6 h of CIT (LTx-6h-CIT). The lung function, edema formation, macroscopic and microscopic changes were assessed. CLDN4 expression in BALF and pulmonary tissue were determined. RESULTS Both groups presented similar clinical, edema, and histological damage, as well as similar expression of CLDN4 in BALF and tissue (p > 0.05, RM-ANOVA). CONCLUSION CLDN4 expressed in BALF and the pulmonary tissue during the first 5 h within 72 h of the PGD window are not associated by the deterioration of lung function, edema and lung histological injury, in LTx with CIT 50 min or 6 h, CLDN4 does not seem to be a valuable indicator of LIRI.
Collapse
Affiliation(s)
- Antonia Luna-Flores
- Lung Transplantation Research Unit, Department of Surgical Research, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico
| | - J Raúl Olmos-Zuñiga
- Lung Transplantation Research Unit, Department of Surgical Research, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico
| | - Rogelio Jasso-Victoria
- Department of Surgical Research, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico
| | - Miguel Gaxiola-Gaxiola
- Department of Morphology, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico
| | - Teresa Aguirre-Pérez
- Bronchoscopy and Endoscopy Service, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico
| | - Victor Ruiz
- Molecular Biology Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico
| | - Rogelio García-Torrentera
- Respiratory Emergency Unit, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico
| | - Mariana Silva-Martínez
- Lung Transplantation Research Unit, Department of Surgical Research, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico
| | - Edgar Zenteno
- Department of Biochemistry, Facultad de Medicina, Universidad Nacional Autónoma de Mexico, Mexico City, Mexico
| | - Gabriel Gutierrez-Ospina
- Department of Cell Biology and Physiology, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de Mexico, Mexico City, Mexico
| | - Patricio Santillan-Doherty
- Medical Direction, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico
| |
Collapse
|
2
|
Ali A, Watanabe Y, Galasso M, Watanabe T, Chen M, Fan E, Brochard L, Ramadan K, Ribeiro RVP, Stansfield W, Gokhale H, Gazzalle A, Waddell T, Liu M, Keshavjee S, Cypel M. An extracellular oxygen carrier during prolonged pulmonary preservation improves post-transplant lung function. J Heart Lung Transplant 2020; 39:595-603. [PMID: 32334946 DOI: 10.1016/j.healun.2020.03.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/06/2020] [Accepted: 03/25/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The use of a novel extracellular oxygen carrier (EOC) preservation additive known as HEMO2Life has recently been shown to lead to a superior preservation of different types of solid organs. Our study aimed to investigate the effect of this EOC on extending lung preservation time and its mechanism of action. METHODS Donor pigs were randomly allocated to either of the following 2 groups (n = 6 per group): (1) 36 hours cold preservation or (2) 36 hours cold preservation with 1 g/liter of EOC. The lungs were evaluated through 12 hours of normothermic ex vivo lung perfusion (EVLP) followed by a left-single lung transplant into a recipient pig. Grafts were reperfused for 4 hours, followed by right pulmonary artery clamping to assess graft oxygenation function. RESULTS During EVLP assessment, EOC-treated lungs showed improvements in physiologic parameters, whereas the control lungs deteriorated. After a total of 48 hours of preservation (36 hours cold + 12 hours normothermic EVLP), transplanted grafts in the treatment group displayed significantly better oxygenation than in the controls (PaO2/FiO2: 437 ± 36 mm Hg vs 343 ± 27 mm Hg, p = 0.041). In addition, the use of EOC led to significantly less edema formation (wet-to-dry ratio: 4.95 ± 0.29 vs 6.05 ± 0.33, p = 0.026), less apoptotic cell death (p = 0.041), improved tight junction preservation (p = 0.002), and lower levels of circulating IL-6 within recipient plasma (p = 0.004) compared with non-use of EOC in the control group after transplantation. CONCLUSION The use of an EOC during an extended pulmonary preservation period led to significantly superior early post-transplant lung function.
Collapse
Affiliation(s)
- Aadil Ali
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Yui Watanabe
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Marcos Galasso
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Tatsuaki Watanabe
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Manyin Chen
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Eddy Fan
- Divisions of Respirology and Critical Care Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Laurent Brochard
- Divisions of Respirology and Critical Care Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Khaled Ramadan
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Rafaela Vanin Pinto Ribeiro
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - William Stansfield
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Hemant Gokhale
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Anajara Gazzalle
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Thomas Waddell
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Mingyao Liu
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Shaf Keshavjee
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Marcelo Cypel
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada.
| |
Collapse
|
3
|
Relaxin Positively Influences Ischemia-Reperfusion Injury in Solid Organ Transplantation: A Comprehensive Review. Int J Mol Sci 2020; 21:ijms21020631. [PMID: 31963613 PMCID: PMC7013572 DOI: 10.3390/ijms21020631] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/07/2020] [Accepted: 01/17/2020] [Indexed: 02/07/2023] Open
Abstract
In recent decades, solid organ transplantation (SOT) has increased the survival and quality of life for patients with end-stage organ failure by providing a potentially long-term treatment option. Although the availability of organs for transplantation has increased throughout the years, the demand greatly outweighs the supply. One possible solution for this problem is to extend the potential donor pool by using extended criteria donors. However, organs from such donors are more prone to ischemia reperfusion injury (IRI) resulting in higher rates of delayed graft function, acute and chronic graft rejection and worse overall SOT outcomes. This can be overcome by further investigating donor preconditioning strategies, graft perfusion and storage and by finding novel therapeutic agents that could reduce IRI. relaxin (RLX) is a peptide hormone with antifibrotic, antioxidant, anti-inflammatory and cytoprotective properties. The main research until now focused on heart failure; however, several preclinical studies showed its potentials for reducing IRI in SOT. The aim of this comprehensive review is to overview currently available literature on the possible role of RLX in reducing IRI and its positive impact on SOT.
Collapse
|
4
|
Moon S, Park MS, Lee JG, Jung JY, Kang YA, Kim YS, Kim SK, Chang J, Paik HC, Kim SY. Risk factors and outcome of primary graft dysfunction after lung transplantation in Korea. J Thorac Dis 2016; 8:3275-3282. [PMID: 28066607 DOI: 10.21037/jtd.2016.11.48] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Primary graft dysfunction (PGD) is a severe, acute and post-transplantation lung injury associated with early morbidity and mortality. We aimed to identify clinical risk factors for PGD, as well as the outcome of PGD after lung transplantation in Korea. METHODS We retrospectively analyzed lung transplant patients in a South Korean Hospital. The primary outcome was grade 3 PGD, defined according to the International Society for Heart and Lung Transplantation criteria. We compared grade 0-2 PGD group to grade 3 PGD group to identify the risk factors and outcome of grade 3 PGD. RESULTS Sixty-one patients were enrolled; 16 (26.2%) developed grade 3 PGD. Univariate analysis revealed higher body mass index (BMI) and history of smoking, extracorporeal membrane oxygenation (ECMO) before transplantation in recipients, and an extended intraoperative ischemic time as risk factors for grade 3 PGD. In multivariate analysis, independent risk factors for PGD were higher BMI in recipients [odds ratio (OR), 1.286; P=0.043] and total intraoperative ischemic time (OR, 1.028; P=0.007). As compared to grade 0-2 PGD, grade 3 PGD was significantly associated with a higher re-operation rate (grade 0-2 PGD vs. grade 3 PGD, 22.2% vs. 50.0%; P=0.036), prolonged ventilator apply (median: 6.0 vs. 14.5 days; P=0.044), a longer intensive care unit stay (median: 9.0 vs. 17.0 days; P=0.041), and a higher rate of renal replacement therapy (RRT) (17.8% vs. 62.5%; P=0.002) after transplantation. CONCLUSIONS Patients who developed grade 3 PGD had higher re-operation rate, longer ventilator apply, longer intensive care unit stay, higher rate of RRT, with higher BMI and total intraoperative ischemic time being the significant risk factor. These findings may allow physicians to modify risk factors before development of PGD.
Collapse
Affiliation(s)
- Sungwoo Moon
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Moo Suk Park
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Gu Lee
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Ye Jung
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Young Ae Kang
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Young Sam Kim
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Se Kyu Kim
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Joon Chang
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Hyo Chae Paik
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Song Yee Kim
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
5
|
Liu R, Fang X, Meng C, Xing J, Liu J, Yang W, Li W, Zhou H. Lung inflation with hydrogen during the cold ischemia phase decreases lung graft injury in rats. Exp Biol Med (Maywood) 2015; 240:1214-22. [PMID: 25662956 DOI: 10.1177/1535370214563895] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Accepted: 10/22/2014] [Indexed: 11/17/2022] Open
Abstract
Hydrogen has antioxidant and anti-inflammatory effects on lung ischemia-reperfusion injury when it is inhaled by donor or/and recipient. This study examined the effects of lung inflation with 3% hydrogen during the cold ischemia phase on lung graft function in rats. The donor lung was inflated with 3% hydrogen, 40% oxygen, and 57% nitrogen at 5 mL/kg, and the gas was replaced every 20 min during the cold ischemia phase for 2 h. In the control group, the donor lung was inflated with 40% oxygen and 60% nitrogen at 5 mL/kg. The recipient was euthanized 2 h after orthotropic lung transplantation. The hydrogen concentration in the donor lung during the cold ischemia phase was 1.99-3%. The oxygenation indices in the arterial blood and pulmonary vein blood were improved in the hydrogen group. The inflammation response indices, including lung W/D ratio, the myeloperoxidase activity in the grafts, and the levels of IL-8 and TNF-α in serum, were significantly lower in the hydrogen group (5.2 ± 0.8, 0.76 ± 0.32 U/g, 340 ± 84 pg/mL, and 405 ± 115 pg/mL, respectively) than those in the control group (6.5 ± 0.7, 1.1 ± 0.5 U/g, 443 ± 94 pg/mL, and 657 ± 96 pg/mL, respectively (P < 0.05), and the oxidative stress indices, including the superoxide dismutase activity and the level of malonaldehyde in lung grafts were improved after hydrogen application. Furthermore, the lung injury score determined by histopathology, the cell apoptotic index, and the caspase-3 protein expression in lung grafts were decreased after hydrogen treatment, and the static pressure-volume curve of lung graft was improved by hydrogen inflation. In conclusion, lung inflation with 3% hydrogen during the cold ischemia phase alleviated lung graft injury and improved graft function.
Collapse
Affiliation(s)
- Rongfang Liu
- Department of Anesthesiology, The Second Affiliated Hospital, Harbin Medical University, Harbin 150081, China Hei Long Jiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Harbin 150081, China
| | - Xianhai Fang
- Department of Anesthesiology, The Second Affiliated Hospital, Harbin Medical University, Harbin 150081, China Hei Long Jiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Harbin 150081, China
| | - Chao Meng
- Department of Anesthesiology, The Second Affiliated Hospital, Harbin Medical University, Harbin 150081, China Hei Long Jiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Harbin 150081, China
| | - Jingchun Xing
- Department of Anesthesiology, The Second Affiliated Hospital, Harbin Medical University, Harbin 150081, China Hei Long Jiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Harbin 150081, China
| | - Jinfeng Liu
- Department of Anesthesiology, The Second Affiliated Hospital, Harbin Medical University, Harbin 150081, China Hei Long Jiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Harbin 150081, China
| | - Wanchao Yang
- Department of Anesthesiology, The Second Affiliated Hospital, Harbin Medical University, Harbin 150081, China Hei Long Jiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Harbin 150081, China
| | - Wenzhi Li
- Department of Anesthesiology, The Second Affiliated Hospital, Harbin Medical University, Harbin 150081, China Hei Long Jiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Harbin 150081, China
| | - Huacheng Zhou
- Department of Anesthesiology, The Second Affiliated Hospital, Harbin Medical University, Harbin 150081, China Hei Long Jiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Harbin 150081, China Department of Anesthesiology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin 150081, China
| |
Collapse
|
6
|
|
7
|
Papel de los biomarcadores en el diagnóstico diferencial de la insuficiencia respiratoria aguda en el postoperatorio inmediato del trasplante pulmonar. Med Intensiva 2013; 37:416-22. [DOI: 10.1016/j.medin.2013.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 01/02/2013] [Accepted: 01/06/2013] [Indexed: 12/21/2022]
|
8
|
Masnou N, Rello J. The impact of lung transplantation on ICU personnel. Med Intensiva 2013; 37:206-8. [PMID: 23398845 DOI: 10.1016/j.medin.2012.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 12/18/2012] [Accepted: 12/19/2012] [Indexed: 11/19/2022]
Affiliation(s)
- N Masnou
- Transplant Coordination Department, Vall d'Hebron University Hospital, Barcelona, Spain.
| | | |
Collapse
|