%0 Journal Article
%T Pilot Trial of Extended Hypothermic Lung Preservation to Analyze Ischemia-reperfusion Injury in Pigs.
%A Ojanguren A
%A Santamaría M
%A Milla-Collado L
%A Fraile C
%A Gatius-Calderó S
%A Puy S
%A Boldó A
%A Gómez-Olles S
%A Boada-Pérez M
%A Esquinas C
%A Sáez-Giménez B
%A Ojanguren I
%A Barrecheguren M
%A Olsina-Kissler JJ
%J Arch Bronconeumol
%V 57
%N 7
%D Jul 2021
%M 35698954
%F 6.333
%R 10.1016/j.arbr.2021.03.015
%X <B>BACKGROUND: </B>In lung transplantation (LT), the length of ischemia time is controversial as it was arbitrarily stablished. We ought to explore the impact of extended cold-ischemia time (CIT) on ischemia-reperfusion injury in an experimental model.<BR><B>METHODS: </B>Experimental, randomized pilot trial of parallel groups and final blind analysis using a swine model of LT. Donor animals (n=8) were submitted to organ procurement. Lungs were subjected to 6h (n=4) or 12h (n=4) aerobic hypothermic preservation. The left lung was transplanted and re-perfused for 4h. Lung biopsies were obtained at (i) the beginning of CIT, (ii) the end of CIT, (iii) 30min after reperfusion, and (iv) 4h after reperfusion. Lung-grafts were histologically assessed by microscopic lung injury score and wet-to-dry ratio. Inflammatory response was measured by determination of inflammatory cytokines. Caspase-3 activity was determined as apoptosis marker.<BR><B>RESULTS: </B>We observed no differences on lung injury score or wet-to-dry ratio any given time between lungs subjected to 6h-CIT or 12h-CIT. IL-1β and IL6 showed an upward trend during reperfusion in both groups. TNF-α was peaked within 30min of reperfusion. IFN-γ was hardly detected. Caspase-3 immunoexpression was graded semiquantitatively by the percentage of stained cells. Twenty percent of apoptotic cells were observed 30min after reperfusion.<BR><B>CONCLUSIONS: </B>We observed that 6 and 12h of CIT were equivalent in terms of microscopic lung injury, inflammatory profile and apoptosis in a LT swine model. The extent of lung injury measured by microscopic lung injury score, proinflammatory cytokines and caspase-3 determination was mild.