J. Hunter Mehaffey, MD, Eric J. Charles, MD, Ashish K

Slides:

Advertisements

Similar presentations

Ex Vivo Lung Perfusion with Adenosine A2A Receptor Agonist Decreases Ischemia-Reperfusion Injury in Donation after Cardiac Death CE Wagner, NH Pope, EJ.

Advertisements

Marcelo Cypel, MD, MSc, Jonathan C

Inhibition of Na-K-Cl cotransporter isoform 1 reduces lung injury induced by ischemia– reperfusion Chou-Chin Lan, MD, PhD, Chung-Kan Peng, MD, PhD, Shih-En.

The eighth edition TNM stage classification for lung cancer: What does it mean on main street? Frank C. Detterbeck, MD The Journal of Thoracic and Cardiovascular.

Mary E. Huerter, MD, MA, Ashish K

Francisco Igor B. Macedo, MD, Enisa M

Experience from the Thoracic Surgery Residents Association traveling fellowship: Adult and pediatric lung transplantation in Toronto Taufiek Konrad Rajab,

One in every 14 patients with early-stage lung cancer is not being treated! Benny Weksler, MD, MBA The Journal of Thoracic and Cardiovascular Surgery

Carbon monoxide reduces pulmonary ischemia–reperfusion injury in miniature swine Hisashi Sahara, MD, Akira Shimizu, MD, PhD, Kentaro Setoyama, DVM, PhD,

Yesterday's heroic measure is now standard procedure: Extracorporeal membrane oxygenation as a bridge to lung transplant Victor van Berkel, MD, PhD

Postmortem and ex vivo carbon monoxide ventilation reduces injury in rat lungs transplanted from non–heart-beating donors Boming Dong, MD, PhD, Paul.

Pablo G. Sanchez, MD, PhD, Keshava Rajagopal, MD, PhD, Si M

Improving long-term survival by preventing early complications after lung transplantation: Can we prevent ripples by keeping pebbles out of the water?

Adenosine A2A receptor activation on CD4+ T lymphocytes and neutrophils attenuates lung ischemia–reperfusion injury Ashish K. Sharma, MBBS, Victor E.

Lung transplantation with donation after cardiac death donors: Long-term follow-up in a single center Nilto C. De Oliveira, MD, Satoru Osaki, MD, PhD,

The impact of tidal volume on pulmonary complications following minimally invasive esophagectomy: A randomized and controlled study Yaxing Shen, MD,

The days of future past Neel K. Ranganath, MD, Aubrey C. Galloway, MD

Inhaled nitric oxide reduces ischemia-reperfusion injury in rat lungs from non–heart- beating donors Seiki Takashima, MD, Giovanna Koukoulis, MD, Hidetoshi.

Pulmonary vein stenosis: Challenges ahead

Ex vivo rehabilitation of non–heart-beating donor lungs in preclinical porcine model: Delayed perfusion results in superior lung function Daniel P. Mulloy,

The evolution of ischemic spinal cord injury in function, cytoarchitecture, and inflammation and the effects of adenosine A2A receptor activation T.

Hemoconcentration in ex vivo lung perfusion: A case report of a novel technique used in clinical lung transplantation Andreas Wallinder, MD, Christoffer.

Eric J. Charles, MD, Mary E. Huerter, MD, MA, Cynthia E

Ex vivo lung perfusion with adenosine A2A receptor agonist allows prolonged cold preservation of lungs donated after cardiac death Cynthia E. Wagner,

Centers for Disease Control “increased-risk” organ donor: Not so risky? Francis D. Pagani, MD, PhD The Journal of Thoracic and Cardiovascular Surgery

Ex Vivo Evaluation of Human Lungs for Transplant Suitability

Form ever follows function

Victor van Berkel, MD, PhD

Effect of preoperative inhaled budesonide on pulmonary injury after cardiopulmonary bypass: A randomized pilot study Wei Gao, MD, Na Li, MS, Zhe-hao.

Surfactant Improves Graft Function After Gastric Acid–Induced Lung Damage in Lung Transplantation Ilhan Inci, MD, Sven Hillinger, MD, Stephan Arni, PhD,

William M. DeCampli, MD, PhD

Marye J. Gleva, MD, Charles B. Huddleston, MD

Inhibiting CXCL12 blocks fibrocyte migration and differentiation and attenuates bronchiolitis obliterans in a murine heterotopic tracheal transplant model

New treatment approaches create new disease processes: A short guide on how to reduce unexpected events to a minimum Martin Czerny, MD, MBA The Journal.

Single-dose rosuvastatin ameliorates lung ischemia–reperfusion injury via upregulation of endothelial nitric oxide synthase and inhibition of macrophage.

Activated protein C attenuates cardiopulmonary bypass–induced acute lung injury through the regulation of neutrophil activation Sachiko Yamazaki, MD,

Abbas Emaminia, MD, Damien J

The protective effect of prone lung position on ischemia–reperfusion injury and lung function in an ex vivo porcine lung model Hiromichi Niikawa, MD,

Inflammatory lung injury after cardiopulmonary bypass is attenuated by adenosine A2A receptor activation Turner C. Lisle, MD, Leo M. Gazoni, MD, Lucas.

The lord of the rings Antonio Miceli, MD, PhD

Satona Tanaka, MD, Toyofumi F

Jared P. Beller, MD, Irving L. Kron, MD

A first start for lung transplantation?

Ashok Muniappan, MD The Journal of Thoracic and Cardiovascular Surgery

Which is better to preserve pulmonary function: Short-term or prolonged leukocyte depletion during cardiopulmonary bypass? Kaiyu Tao, MD, Qi An, MD,

CD4+ T lymphocytes mediate acute pulmonary ischemia–reperfusion injury

Leora B. Balsam, MD, Abe DeAnda, MD

Eight and counting The Journal of Thoracic and Cardiovascular Surgery

The Ross procedure: Time to reevaluate the guidelines

Daniel P. Mulloy, MD, Ashish K. Sharma, MBBS, PhD, Lucas G

Video-assisted resection for lung cancer results in fewer complications Lunxu Liu, PhD, MD, FRCS The Journal of Thoracic and Cardiovascular Surgery

Hyperoxic ventilation exacerbates lung reperfusion injury

Passing the torch The Journal of Thoracic and Cardiovascular Surgery

How much is enough to warrant prophylactic tricuspid repair?

Reduced neutrophil infiltration protects against lung reperfusion injury after transplantation Scott D Ross, MD, Curtis G Tribble, MD, John R Gaughen,

Unilateral lung transplantation using right and left upper lobes: An experimental study Hitoshi Nishikawa, MD, Takahiro Oto, MD, PhD, Shinji Otani, MD,

The origins of open heart surgery at the University of Minnesota 1951 to 1956 Richard A. DeWall, MD The Journal of Thoracic and Cardiovascular Surgery

Johanna Bayer, MD, Nitin A. Das, MD, Clinton E

The Journal of Thoracic and Cardiovascular Surgery

Discussion The Journal of Thoracic and Cardiovascular Surgery

The future of cardiac surgery training: A survival guide

Intratracheal Surfactant Administration Preserves Airway Compliance During Lung Reperfusion Scott A Buchanan, Michael C Mauney, Vikas I Parekh, Nuno.

After neoadjuvant chemoradiation therapy, predicted pulmonary function may be reduced by 10% Benny Weksler, MD, MBA The Journal of Thoracic and Cardiovascular.

“The more things change…”: The challenges ahead

Toll-like receptor 4 inhibition attenuates ischemia-reperfusion injury in rats: Will it work in human beings? Chadrick E. Denlinger, MD The Journal.

Energized lung resections

Lung cancer randomized controlled trials should compare stereotactic body radiation therapy with observation, NOT surgery Raja M. Flores, MD The Journal.

Preoperative PFTs: The answer is blowing in the wind

Marcelo Cypel, MD, MSc, Jonathan C

Deciding how much to pay for effective care

Presentation transcript:

Airway pressure release ventilation during ex vivo lung perfusion attenuates injury J. Hunter Mehaffey, MD, Eric J. Charles, MD, Ashish K. Sharma, MBBS, PhD, Dustin T. Money, RRT-ACCS, Yunge Zhao, MD, PhD, Mark H. Stoler, MD, Christine L. Lau, MD, MBA, Curtis G. Tribble, MD, Victor E. Laubach, PhD, Mark E. Roeser, MD, Irving L. Kron, MD The Journal of Thoracic and Cardiovascular Surgery Volume 153, Issue 1, Pages 197-204 (January 2017) DOI: 10.1016/j.jtcvs.2016.09.029 Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Changes in Pao2/Fio2 ratios of the left lung over the course of the experiment. Pao2/Fio2 ratios were significantly higher in the APRV group after transplantation at both the 2-hour and 4-hour reperfusion times. Pao2, Partial pressure of oxygen; Fio2, inspired oxygen fraction; APRV, airway pressure release ventilation; EVLP, ex vivo lung perfusion. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 197-204DOI: (10.1016/j.jtcvs.2016.09.029) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Changes in Pao2/Fio2 ratios and dynamic compliance during EVLP. A, No significant differences in Pao2/Fio2 ratios during EVLP were observed between the control and APRV groups. B, Dynamic compliance throughout the 4 hours of EVLP was similar for both groups. Pao2, Partial pressure of oxygen; Fio2, inspired oxygen fraction; APRV, airway pressure release ventilation; EVLP, ex vivo lung perfusion. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 197-204DOI: (10.1016/j.jtcvs.2016.09.029) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Lung function and edema after transplantation. Pao2/Fio2 ratios (A) and dynamic lung compliance (B) were significantly improved in the APRV group at both 2 and 4 hours of post-transplant reperfusion. C, Pulmonary edema, as a percent weight change after 4 hours of reperfusion, was significantly reduced in the APRV group during EVLP versus control, but there was no significant difference after post-transplant reperfusion. Pao2, Partial pressure of oxygen; Fio2, inspired oxygen fraction; APRV, airway pressure release ventilation; EVLP, ex vivo lung perfusion. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 197-204DOI: (10.1016/j.jtcvs.2016.09.029) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Lung tissue expression of proinflammatory cytokines in the left lungs of the APRV and control groups, as well as in post-EVLP right lungs. Several cytokines (IL-6 and IL-12) were significantly elevated in the control group but significantly reduced in the APRV group. IL, Interleukin; EVLP, ex vivo lung perfusion; APRV, airway pressure release ventilation. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 197-204DOI: (10.1016/j.jtcvs.2016.09.029) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Representative lung hematoxylin–eosin histology images from the control and APRV groups (A). Although lower in the APRV group, lung injury severity scores were not significantly different between the control and APRV groups (B). APRV, Airway pressure release ventilation. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 197-204DOI: (10.1016/j.jtcvs.2016.09.029) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 Representative images of immunohistochemistry staining for neutrophils in lung sections from both groups after transplantation and 4 hours of reperfusion (A). Neutrophil counts per high-powered field were significantly reduced in the APRV group versus control (B). APRV, Airway pressure release ventilation; HPF, high-powered field. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 197-204DOI: (10.1016/j.jtcvs.2016.09.029) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

APRV during EVLP improves oxygenation post-transplant despite no difference in EVLP. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 197-204DOI: (10.1016/j.jtcvs.2016.09.029) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Video 1 Porcine procurement and left lung transplant model. Video available at: http://www.jtcvsonline.org/article/S0022-5223(16)31147-3/addons. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 197-204DOI: (10.1016/j.jtcvs.2016.09.029) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions