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Published on: January 28, 2020
Effect of intraoperative support mode on circulating inflammatory biomarkers after lung transplantation surgery
Lourdes Chacon-Alberty1, Shengbin Ye2, Abdussalam Elsenousi3
1Department of Regenerative Medicine Research, Texas Heart Institute, Houston, Texas, USA.
Background:
Processes that activate the immune system during lung transplantation can lead to primary graft dysfunction (PGD) or allograft rejection.
Methods:
We analyzed cytokine expression profiles after reperfusion and allograft outcomes in a cohort of patients (n = 59) who underwent lung transplantation off-pump (n = 26), with cardiopulmonary bypass (CPB; n = 18), or with extracorporeal membrane oxygenation (ECMO; n = 15). Peripheral blood was collected from patients at baseline and at 6 and 72 h after reperfusion. To adjust for clinical differences between groups, we utilized a linear mixed model with overlap weighting.
Results:
PGD3 was present at 48 or 72 h after reperfusion in 7.7% (2/26) of off-pump cases, 20.0% (3/15) of ECMO cases, and 38.9% (7/18) of CPB cases (p = 0.04). The ECMO and CPB groups had greater reperfusion-induced increases in MIP-1B, IL-6, IL-8, IL-9, IL1-ra, TNF-alpha, RANTES, eotaxin, IP-10, and MCP-1 levels than the off-pump group. Cytokine expression profiles after reperfusion were not significantly different between ECMO and CPB groups.
Conclusion:
Our data suggest that, compared with an off-pump approach, the intraoperative use of ECMO or CPB during lung transplantation is associated with greater reperfusion-induced cytokine release and graft injury.
