由于满足标准的供体肺的短缺,肺移植的数量是有限的。离体肺灌注(EVLP)技术提供了重新评估和潜在地改善和治疗边缘供体肺的能力。因此,该技术已成为增加急需的供体肺库的重要工具。主要的EVLP协议之一,隆德协议,以高肺动脉流量(100%的心输出量[CO])为特征,一个开放的中庭,和细胞灌注液,已经证明了令人鼓舞的短EVLP持续时间结果。然而,该方案的EVLP持续时间较长的可能性尚待研究,一个持续时间,这被认为是必要的,以拯救更多的边缘供肺在未来。这项研究旨在使用具有三种不同肺动脉流量的开放心房细胞模型实现稳定的8小时EVLP,除了确定最佳肺部表现方面的最佳流量外,包括肺电解质和最少的肺水肿形成,灌注液和组织炎症,和组织病理学变化,用猪模型.使用40%(n=6)的流量进行EVLP,80%(n=6),或100%(n=6)的CO。无流速显示8小时EVLP稳定。在所有三组中均观察到稳定的2小时EVLP。在动态顺应性中观察到无显着的恶化,峰值气道压力,和组间的氧合。40%组肺血管阻力显著增加(p<0.05)。随着EVLP的延长,电解质表现出微不足道的恶化趋势。灌注液和组织中的白细胞介素-8(IL-8),湿干重量比,EVLP后的组织病理学变化在各组之间没有明显的时间依赖性。这项研究表明,无论流量为40%,稳定的8小时EVLP在开放心房细胞模型中是不可行的。80%,或100%的CO。在肺部表现方面没有更好的流量,肺电解质变化,肺水肿形成最少,灌注液和组织中IL-8的最低表达,和组织病理学变化。
The number of lung transplantations is limited due to the shortage of donor lungs fulfilling the standard criteria. The ex vivo lung perfusion (EVLP) technique provides the ability of re-evaluating and potentially improving and treating marginal donor lungs. Accordingly, the technique has emerged as an essential tool to increase the much-needed donor lung pool. One of the major EVLP protocols, the Lund protocol, characterized by high pulmonary artery flow (100% of cardiac output [CO]), an open atrium, and a cellular perfusate, has demonstrated encouraging short-EVLP duration results. However, the potential of the longer EVLP duration of the protocol is yet to be investigated, a duration which is considered necessary to rescue more marginal donor lungs in future. This study aimed to achieve stable 8-h EVLP using an open-atrium cellular model with three different pulmonary artery flows in addition to determining the most optimal flow in terms of best lung performance, including lung electrolytes and least lung edema formation, perfusate and tissue inflammation, and histopathological changes, using the porcine model. EVLP was performed using a flow of either 40% (n = 6), 80% (n = 6), or 100% (n = 6) of CO. No flow rate demonstrated stable 8-h EVLP. Stable 2-h EVLP was observed in all three groups. Insignificant deterioration was observed in dynamic compliance, peak airway pressure, and oxygenation between the groups. Pulmonary vascular resistance increased significantly in the 40% group (p < .05). Electrolytes demonstrated an insignificant worsening trend with longer EVLP. Interleukin-8 (IL-8) in perfusate and tissue, wet-to-dry weight ratio, and histopathological changes after EVLP were insignificantly time dependent between the groups. This study demonstrated that stable 8-h EVLP was not feasible in an open-atrium cellular model regardless of the flow of 40%, 80%, or 100% of CO. No flow was superior in terms of lung performance, lung electrolytes changes, least lung edema formation, minimal IL-8 expression in perfusate and tissue, and histopathological changes.