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Related Experiment Videos

Use of leukocyte depletion to decrease injury after lung preservation and rewarming ischemia: an experimental model

Y Shiraishi1, J R Lee, H Laks

  • 1Division of Cardiothoracic Surgery, UCLA Medical Center, Los Angeles, California 90095, USA.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|May 1, 1998
PubMed
Summary

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Rewarming during lung implantation causes significant injury. Short-term leukocyte depletion during reperfusion can minimize this lung preservation damage, improving outcomes for lung transplantation.

Area of Science:

  • Cardiovascular Surgery
  • Pulmonary Medicine
  • Transplantation Immunology

Background:

  • Maintaining optimal lung preservation temperature is crucial during the ischemic interval.
  • Lung rewarming during implantation is a common occurrence that can lead to preservation injury.
  • Investigating the impact of rewarming ischemia and potential mitigation strategies is vital for improving lung transplantation outcomes.

Purpose of the Study:

  • To investigate the severity of rewarming ischemia on lung preservation injury.
  • To explore the potential of leukocyte depletion during initial reperfusion to minimize rewarming-induced injury.

Main Methods:

  • Neonatal piglet heart-lung blocks were used in four experimental groups.
  • Groups included a control (no ischemia), whole blood (WB) reperfusion after 13 hours of preservation, rewarming with WB (RWB) after 12 hours preservation and 1 hour rewarming, and initial leukocyte-depleted blood reperfusion followed by WB.

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  • All groups were studied on an isolated, blood-perfused, working heart-lung circuit for 4 hours.

    • Main Results:

    • The RWB group exhibited significantly lower partial pressure of arterial oxygen and lung compliance compared to controls.
    • Pulmonary vascular resistance and lung wet/dry weight ratios were significantly higher in the RWB group versus controls.
    • No significant differences were observed between WB or leukocyte-depleted groups and controls for measured parameters.

    Conclusions:

    • Rewarming ischemia during lung implantation exacerbates reperfusion injury.
    • Short-term (10 minutes) leukocyte-depleted reperfusion effectively ameliorates this injury.
    • Leukocyte-depleted reperfusion should be considered for clinical lung transplantation to reduce injury.