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Protection of pulmonary graft from thrombosis in donation after cardiac death : Effect of warm ischaemia versus cold ischaemia

Pierre, Leif LU ; Lindstedt, Sandra LU and Ingemansson, Richard LU (2016) In Interactive Cardiovascular and Thoracic Surgery 23(5). p.705-709
Abstract

OBJECTIVES The use of donation after cardiac death (DCD) to overcome organ shortage is slowly moving into the clinic. In this study, we compare the protective effect of warm ischaemia versus cold ischaemia on thrombotic formation in non-heparinized pulmonary grafts. METHODS Twelve Landrace pigs were randomized into two groups: warm ischaemia and cold ischaemia. Ventricular fibrillation without the administration of heparin was induced to mimick an uncontrolled DCD situation. The animals were then exposed to either 1 h of cold ischaemia (insertion of drain and installation of cold fluid in the pleuras) or warm ischaemia (body temperature). After 1 h, the pulmonary artery was opened and the pulmonary arterial branches were then... (More)

OBJECTIVES The use of donation after cardiac death (DCD) to overcome organ shortage is slowly moving into the clinic. In this study, we compare the protective effect of warm ischaemia versus cold ischaemia on thrombotic formation in non-heparinized pulmonary grafts. METHODS Twelve Landrace pigs were randomized into two groups: warm ischaemia and cold ischaemia. Ventricular fibrillation without the administration of heparin was induced to mimick an uncontrolled DCD situation. The animals were then exposed to either 1 h of cold ischaemia (insertion of drain and installation of cold fluid in the pleuras) or warm ischaemia (body temperature). After 1 h, the pulmonary artery was opened and the pulmonary arterial branches were then macroscopically studied for thrombotic material. RESULTS After 60 min, the temperature was 36.6 ± 0.0°C in the warm ischaemic group and 14.6 ± 0.1°C in the cold ischaemic group (P < 0.001). In the warm ischaemic group, no thrombotic material could be found in the pulmonary artery in the animals examined and in the cold ischaemic group 6.8 ± 0.2 ml thrombotic material was found in the pulmonary artery (P < 0.001). In the warm ischaemic group, no thrombotic material could be found in the arterial branches of the pulmonary artery and in the cold ischaemic group 2.3 ± 0.1 ml thrombotic material was found in the arterial branches of the pulmonary artery (P < 0.001). CONCLUSIONS Warm ischaemia rather than cold ischaemia seems to protect the pulmonary graft from thrombosis in uncontrolled non-heparinized DCD pigs.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Donation after cardiac death, Experimental, Lung transplantation, Thrombosis, Warm ischaemia
in
Interactive Cardiovascular and Thoracic Surgery
volume
23
issue
5
pages
5 pages
publisher
European Association of Cardio-Thoracic Surgery
external identifiers
  • scopus:84994577416
  • wos:000388000500005
ISSN
1569-9293
DOI
10.1093/icvts/ivw225
language
English
LU publication?
yes
id
9705d192-d9c8-4127-a82b-9a07f54e2ef6
date added to LUP
2016-12-05 10:42:07
date last changed
2017-01-01 08:41:55
@article{9705d192-d9c8-4127-a82b-9a07f54e2ef6,
  abstract     = {<p>OBJECTIVES The use of donation after cardiac death (DCD) to overcome organ shortage is slowly moving into the clinic. In this study, we compare the protective effect of warm ischaemia versus cold ischaemia on thrombotic formation in non-heparinized pulmonary grafts. METHODS Twelve Landrace pigs were randomized into two groups: warm ischaemia and cold ischaemia. Ventricular fibrillation without the administration of heparin was induced to mimick an uncontrolled DCD situation. The animals were then exposed to either 1 h of cold ischaemia (insertion of drain and installation of cold fluid in the pleuras) or warm ischaemia (body temperature). After 1 h, the pulmonary artery was opened and the pulmonary arterial branches were then macroscopically studied for thrombotic material. RESULTS After 60 min, the temperature was 36.6 ± 0.0°C in the warm ischaemic group and 14.6 ± 0.1°C in the cold ischaemic group (P &lt; 0.001). In the warm ischaemic group, no thrombotic material could be found in the pulmonary artery in the animals examined and in the cold ischaemic group 6.8 ± 0.2 ml thrombotic material was found in the pulmonary artery (P &lt; 0.001). In the warm ischaemic group, no thrombotic material could be found in the arterial branches of the pulmonary artery and in the cold ischaemic group 2.3 ± 0.1 ml thrombotic material was found in the arterial branches of the pulmonary artery (P &lt; 0.001). CONCLUSIONS Warm ischaemia rather than cold ischaemia seems to protect the pulmonary graft from thrombosis in uncontrolled non-heparinized DCD pigs.</p>},
  author       = {Pierre, Leif and Lindstedt, Sandra and Ingemansson, Richard},
  issn         = {1569-9293},
  keyword      = {Donation after cardiac death,Experimental,Lung transplantation,Thrombosis,Warm ischaemia},
  language     = {eng},
  month        = {11},
  number       = {5},
  pages        = {705--709},
  publisher    = {European Association of Cardio-Thoracic Surgery},
  series       = {Interactive Cardiovascular and Thoracic Surgery},
  title        = {Protection of pulmonary graft from thrombosis in donation after cardiac death : Effect of warm ischaemia versus cold ischaemia},
  url          = {http://dx.doi.org/10.1093/icvts/ivw225},
  volume       = {23},
  year         = {2016},
}