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A Model of Ex Vivo Perfusion of Porcine Donor Lungs Injured by Gastric Aspiration: A Step Towards Pretransplant Reconditioning

2011; Elsevier BV; Volume: 170; Issue: 1 Linguagem: Inglês

10.1016/j.jss.2011.05.015

1095-8673

Caroline Marie F Meers, Sokratis Tsagkaropoulos, Shana Wauters, Erik Verbeken, Bart M. Vanaudenaerde, Hans Scheers, Geert M. Verleden, Dirk Van Raemdonck,

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Background Evidence of aspiration remains a major reason for declining donor lungs contributing to current organ shortage. The aim of the present ex vivo lung perfusion (EVLP) study was to compare lungs injured by gastric juice (GJ) with normal lungs. Methods Pigs (32.3 ± 11.2 kg) were divided into two groups. Study group [GJ; n = 6] was intratracheally instilled with GJ, while sham bronchoscopy was performed in control group [C; n = 6]. Graft function was assessed during EVLP for 2 h. Oxygenation, aerodynamic, and hemodynamic parameters were recorded every 30 min. Wet to dry weight ratio (W/D) was calculated. Bronchoalveolar lavage was performed. Tissue samples were collected. Results Pulmonary vascular resistance was higher and pulmonary flow was lower in [GJ] versus [C] at T120; ( P < 0.05). Mean airway pressure was higher in ( P < 0.05) and compliance was lower ( P < 0.001) in [GJ]. No differences in oxygenation were seen between groups. W/D of left lung in [GJ] after EVLP was slightly ( P < 0.05) higher compared with the nonperfused right lung. More neutrophils were present in [GJ] before ( P < 0.01) and after EVLP ( P < 0.05). Histologic alterations were more prominent in [GJ], but did not worsen after EVLP. Conclusion EVLP of injured lungs is possible for 2 h despite increased edema. This model could help to investigate ways to repair caustic lung injury during EVLP.