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Ventilation in situ after cardiac death improves pulmonary grafts exposed to 2 hours of warm ischemia

Pierre, Leif LU ; Lindstedt Ingemansson, Sandra LU and Ingemansson, Richard LU (2015) In Scandinavian Cardiovascular Journal 49(5). p.293-298
Abstract
Background. The pulmonary donor pool would increase substantially if lungs could be donated after cardiac death (DCD). There have been ethical and legal obstacles since administration of heparin and cooling has to be done immediately after cardiac death. This study examines whether ventilation of DCD lungs without administering heparin or cooling the lungs after cardiac death could improve graft function. Method. Twelve donor pigs with a mean bodyweight of 70 kg were randomized into two groups. Six animals were ventilated in situ with 50% oxygen, 4 L/min, and 5 cm H2O in positive end-expiratory pressure or PEEP for 2 h after cardiac death. Six animals served as non-ventilated controls and were exposed to warm ischemia for 2 h. After 2 h,... (More)
Background. The pulmonary donor pool would increase substantially if lungs could be donated after cardiac death (DCD). There have been ethical and legal obstacles since administration of heparin and cooling has to be done immediately after cardiac death. This study examines whether ventilation of DCD lungs without administering heparin or cooling the lungs after cardiac death could improve graft function. Method. Twelve donor pigs with a mean bodyweight of 70 kg were randomized into two groups. Six animals were ventilated in situ with 50% oxygen, 4 L/min, and 5 cm H2O in positive end-expiratory pressure or PEEP for 2 h after cardiac death. Six animals served as non-ventilated controls and were exposed to warm ischemia for 2 h. After 2 h, all lungs were harvested and flush perfused with Perfadex (R) solution and stored at 8 degrees C for another 2 h. An ex vivo lung perfusion or EVLP circuit was used for evaluation. Results. Non-ventilated lungs developed pulmonary edema, and had highly impaired blood gas levels and a significantly increased weight. The ventilated lungs demonstrated excellent blood gas levels and unchanged weight. Conclusion. The increase in tolerable warm ischemic time in combination with avoiding heparinization and cooling might facilitate the use of DCD lungs for transplantation. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
warm ischemia, ventilation in situ, lungs, DCD
in
Scandinavian Cardiovascular Journal
volume
49
issue
5
pages
293 - 298
publisher
Taylor & Francis
external identifiers
  • wos:000360175600008
  • scopus:84940483320
ISSN
1651-2006
DOI
10.3109/14017431.2015.1052549
language
English
LU publication?
yes
id
233b7afc-ea87-410a-8697-32d067cffabb (old id 7969258)
date added to LUP
2015-09-29 14:53:49
date last changed
2017-08-27 04:37:16
@article{233b7afc-ea87-410a-8697-32d067cffabb,
  abstract     = {Background. The pulmonary donor pool would increase substantially if lungs could be donated after cardiac death (DCD). There have been ethical and legal obstacles since administration of heparin and cooling has to be done immediately after cardiac death. This study examines whether ventilation of DCD lungs without administering heparin or cooling the lungs after cardiac death could improve graft function. Method. Twelve donor pigs with a mean bodyweight of 70 kg were randomized into two groups. Six animals were ventilated in situ with 50% oxygen, 4 L/min, and 5 cm H2O in positive end-expiratory pressure or PEEP for 2 h after cardiac death. Six animals served as non-ventilated controls and were exposed to warm ischemia for 2 h. After 2 h, all lungs were harvested and flush perfused with Perfadex (R) solution and stored at 8 degrees C for another 2 h. An ex vivo lung perfusion or EVLP circuit was used for evaluation. Results. Non-ventilated lungs developed pulmonary edema, and had highly impaired blood gas levels and a significantly increased weight. The ventilated lungs demonstrated excellent blood gas levels and unchanged weight. Conclusion. The increase in tolerable warm ischemic time in combination with avoiding heparinization and cooling might facilitate the use of DCD lungs for transplantation.},
  author       = {Pierre, Leif and Lindstedt Ingemansson, Sandra and Ingemansson, Richard},
  issn         = {1651-2006},
  keyword      = {warm ischemia,ventilation in situ,lungs,DCD},
  language     = {eng},
  number       = {5},
  pages        = {293--298},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Cardiovascular Journal},
  title        = {Ventilation in situ after cardiac death improves pulmonary grafts exposed to 2 hours of warm ischemia},
  url          = {http://dx.doi.org/10.3109/14017431.2015.1052549},
  volume       = {49},
  year         = {2015},
}