Abbas Emaminia, MD, Damien J

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Adenosine A2A Agonist Improves Lung Function During Ex Vivo Lung Perfusion Abbas Emaminia, MD, Damien J. LaPar, MD, MS, Yunge Zhao, MD, PhD, John F. Steidle, MS, David A. Harris, BS, Victor E. Laubach, PhD, Joel Linden, PhD, Irving L. Kron, MD, Christine L. Lau, MD The Annals of Thoracic Surgery Volume 92, Issue 5, Pages 1840-1846 (November 2011) DOI: 10.1016/j.athoracsur.2011.06.062 Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Lungs are placed in the XVIVO evaluation box and are connected to ventilator and perfusion system. Blood flow is from left atrium into a reservoir by gravity. It passes a centrifugal pump, is deoxygenated in an oxygenator, and is pumped back into the lung through the pulmonary artery. Pulmonary artery and left atrial pressures are monitored by specially designed cannulas with built-in pressure lines. The Annals of Thoracic Surgery 2011 92, 1840-1846DOI: (10.1016/j.athoracsur.2011.06.062) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Oxygenation index was significantly improved after 5 hours of ex vivo lung perfusion with Steen Solution and A2A agonist compared with lungs perfused with Steen Solution only; *p < 0.01. (EVLP = ex vivo lung perfusion; A2AR = A2A receptor.) The Annals of Thoracic Surgery 2011 92, 1840-1846DOI: (10.1016/j.athoracsur.2011.06.062) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Lungs after 5 hours of ex vivo lung perfusion (EVLP) with A2A agonist revealed significantly lower mean airway pressure compared with control lungs; *p < 0.009. (A2AR = A2A receptor.) The Annals of Thoracic Surgery 2011 92, 1840-1846DOI: (10.1016/j.athoracsur.2011.06.062) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Comparison of wet-dry (W/D) weight ratio between the treatment and control groups. Low edema formation rates were observed in lungs exposed to the A2A agonist; *p < 0.03. (EVLP = ex vivo lung perfusion; A2AR = A2A receptor.) The Annals of Thoracic Surgery 2011 92, 1840-1846DOI: (10.1016/j.athoracsur.2011.06.062) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Tissue level of interferon gamma (IFN-γ) was significantly lower in treatment lungs after 5 hours of ex vivo lung perfusion (EVLP) and exposure to adenosine A2A agonist; *p < 0.05. (A2AR = A2A receptor.) The Annals of Thoracic Surgery 2011 92, 1840-1846DOI: (10.1016/j.athoracsur.2011.06.062) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions