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

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

Modified In Vivo Lung Perfusion for Local Chemotherapy: A Preclinical Study With Doxorubicin Pedro Reck dos Santos, MD, MS, Jin Sakamoto, MD, Manyin.

Mary E. Huerter, MD, MA, Ashish K

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

Prediction of severe acute kidney injury after pediatric cardiac surgery with the use of novel biomarkers: A new trend in clinical research and risk stratification

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

Controlled low-pressure perfusion at the beginning of reperfusion attenuates neurologic injury after spinal cord ischemia Enyi Shi, MD, PhD, Xiaojing.

Effects of azithromycin and tanomastat on experimental bronchiolitis obliterans Katharina Krenn, MD, Matthias Gmeiner, MD, PhD, Patrick Paulus, MD, Nezir.

Functional evaluation of human donation after cardiac death donor hearts using a continuous isolated myocardial perfusion technique: Potential for expansion.

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,

Short-Course Rapamycin Treatment Preserves Airway Epithelium and Protects Against Bronchiolitis Obliterans Jacob R. Gillen, MD, Yunge Zhao, MD, PhD,

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

Transplantation of initially rejected donor lungs after ex vivo lung perfusion Andreas Wallinder, MD, Sven-Erik Ricksten, MD, PhD, Christoffer Hansson,

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,

Right internal thoracic artery or saphenous vein grafting

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

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

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,

Nebulized nitrite protects rat lung grafts from ischemia reperfusion injury Toshihiro Okamoto, MD, PhD, Xiaoying Tang, MS, Allison Janocha, BS, Caral.

Quantification of caval flow contribution to the lungs in vivo after total cavopulmonary connection with 4-dimensional flow magnetic resonance imaging

Shigeyuki Sasaki, MD, PhD (by invitation), James D

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,

Carbon monoxide–saturated preservation solution protects lung grafts from ischemia– reperfusion injury Junichi Kohmoto, MD, Atsunori Nakao, MD, Ryujiro.

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

Main stem bronchus surgery with pulmonary preservation

Aditya K. Kaza, MD The Journal of Thoracic and Cardiovascular Surgery

Low-potassium dextran solution ameliorates reperfusion injury of the lung and protects surfactant function Martin Strüber, MDa, Jens M. Hohlfeld, MDb,

A first start for lung transplantation?

Ashok Muniappan, MD The Journal of Thoracic and Cardiovascular Surgery

Blockade of receptor for advanced glycation end product attenuates pulmonary reperfusion injury in mice David I. Sternberg, MD, Ram Gowda, BS, Divya.

Hidetoshi Inokawa, MD, PhD, Mayura Sevala, PhD, William K

Validating the use of short interfering RNA as a novel technique for cell-specific target gene knockdown in lung ischemia–reperfusion injury Heather.

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

Hyperoxic ventilation exacerbates lung reperfusion injury

Pathologic correlates of heparin-free donation after cardiac death in lung transplantation Chase R. Brown, BS, Alexis E. Shafii, MD, Carol F. Farver,

Nicorandil, a potent adenosine triphosphate–sensitive potassium-channel opener, ameliorates lung allograft reperfusion injury Motohiro Yamashita, MD,

Passing the torch The Journal of Thoracic and Cardiovascular Surgery

How much is enough to warrant prophylactic tricuspid repair?

Shunt right or left? Decision 2016

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.

Commentary: Avoiding acute kidney injury after cardiac operations: Searching for the holy grail is not easy Victor A. Ferraris, MD, PhD The Journal.

Iloprost to improve surfactant function in porcine pulmonary grafts stored for twenty-four hours in low-potassium dextran solution Bernhard Gohrbandt,

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

Unexpected donor pulmonary embolism affects early outcomes after lung transplantation: A major mechanism of primary graft failure? Takahiro Oto, MD,

Marcelo Cypel, MD, MSc, Jonathan C

Deciding how much to pay for effective care

Presentation transcript:

Ex vivo lung perfusion with adenosine A2A receptor agonist allows prolonged cold preservation of lungs donated after cardiac death Cynthia E. Wagner, MD, Nicolas H. Pope, MD, Eric J. Charles, MD, Mary E. Huerter, MD, Ashish K. Sharma, MBBS, PhD, Morgan D. Salmon, PhD, Benjamin T. Carter, BS, Mark H. Stoler, MD, Christine L. Lau, MD, MBA, Victor E. Laubach, PhD, Irving L. Kron, MD The Journal of Thoracic and Cardiovascular Surgery Volume 151, Issue 2, Pages 538-546 (February 2016) DOI: 10.1016/j.jtcvs.2015.07.075 Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Comparison of initial and final Pao2/Fio2 ratios among groups. Initial donor Pao2/Fio2 ratios were obtained before procurement. Final Pao2/Fio2 ratios of donor lungs were determined from samples obtained from the left superior and inferior pulmonary veins after 4 hours of reperfusion. *P < .0001 versus DMSO. Pao2/Fio2, Arterial oxygen partial pressure/fraction of inspired oxygen; DMSO, dimethyl sulfoxide; ATL-E, A2AR agonist administration during EVLP; ATL-E/R, A2AR agonist administration during EVLP and reperfusion. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 538-546DOI: (10.1016/j.jtcvs.2015.07.075) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Trends in Po2 gradients throughout 4 hours of EVLP in DMSO, ATL-E, and ATL-E/R groups. The red line represents the 350 mm Hg threshold for clinical lung transplantation. Po2, Oxygen tension; EVLP, ex vivo lung perfusion; DMSO, dimethyl sulfoxide; ATL-E, A2AR agonist administration during EVLP; ATL-E/R, A2AR agonist administration during EVLP and reperfusion. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 538-546DOI: (10.1016/j.jtcvs.2015.07.075) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Changes in physiologic parameters throughout 4 hours of EVLP. Peak airway pressure, dynamic compliance, and PVR in the DMSO, ATL-E, and ATL-E/R groups. EVLP, Ex vivo lung perfusion; DMSO, dimethyl sulfoxide; ATL-E, A2AR agonist administration during EVLP; ATL-E/R, A2AR agonist administration during EVLP and reperfusion. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 538-546DOI: (10.1016/j.jtcvs.2015.07.075) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Percent change in peak airway pressure, dynamic compliance, and PVR between the first hour and the fourth hour of EVLP among groups. The red line represents the 15% threshold for clinical lung transplantation. EVLP, Ex vivo lung perfusion; DMSO, dimethyl sulfoxide; ATL-E, A2AR agonist administration during EVLP; ATL-E/R, A2AR agonist administration during EVLP and reperfusion. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 538-546DOI: (10.1016/j.jtcvs.2015.07.075) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Proinflammatory cytokine levels in lung tissue after 4 hours of reperfusion. IL, Interleukin; IFN-γ, interferon gamma; DMSO, dimethyl sulfoxide; ATL-E, A2AR agonist administration during EVLP; ATL-E/R, A2AR agonist administration during EVLP and reperfusion. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 538-546DOI: (10.1016/j.jtcvs.2015.07.075) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 Pulmonary edema after 4 hours of reperfusion as measured by total protein concentration in BAL fluid and lung wet-to-dry weight ratios. BAL, Bronchoalveolar lavage; DMSO, dimethyl sulfoxide; ATL-E, A2AR agonist administration during EVLP; ATL-E/R, A2AR agonist administration during EVLP and reperfusion. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 538-546DOI: (10.1016/j.jtcvs.2015.07.075) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 7 Top, Representative lung histology (hematoxylin and eosin stain at 20× magnification) after 4 hours of reperfusion in DMSO, ATL-E, and ATL-E/R groups. Bottom, Comparison of mean lung injury severity scores among groups as determined from histology. DMSO, Dimethyl sulfoxide; ATL-E, A2AR agonist administration during EVLP; ATL-E/R, A2AR agonist administration during EVLP and reperfusion. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 538-546DOI: (10.1016/j.jtcvs.2015.07.075) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

The treated groups (ATL-E and ATL-E/R) had higher final Pao2/Fio2 ratios than the DMSO group. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 538-546DOI: (10.1016/j.jtcvs.2015.07.075) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions