General thoracic and cardiovascular surgery · 2018
Long agonal period deteriorates cardiac death donor lung function in a rat EVLP model.
СтатьяНазвание и аннотация: Перевод в очереди
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Hijiya Kyoko, Chen-Yoshikawa Toyofumi Fengshi, Motoyama Hideki, Ohsumi Akihiro, Nakajima Daisuke, Sakamoto Jin, Aoyama Akihiro, Date Hiroshi
Аннотация
PURPOSE: We investigated the impact of the duration of agonal period on donor lung function after reperfusion in an ex vivo rat lung perfusion model.
METHODS: Three mechanical hypoventilation conditions were used for three agonal periods, which were defined as the interval between the start of hypoventilation and the time when systolic arterial blood pressure reached < 50 mmHg, i.e., < 10, 30-60, and 150-200 min for very short (VS), short (S), and long (L) groups (n = 5 rats/group). After flushing the lung, heart-lung blocks were reperfused ex vivo for 120 min; physiological data were obtained throughout the reperfusion process.
RESULTS: Pulmonary vascular resistance was significantly higher throughout reperfusion in group L than in the other two groups (p < 0.05). After reperfusion, oxygenation was worse and pulmonary edema was more severe in group L than in group S (p < 0.05). Potassium concentrations in the perfusates were significantly higher in group L than in group VS. Histological analysis revealed more severe injury in group L than in the other two groups.
CONCLUSIONS: Long agonal periods may lead to deterioration of donor lung function; short intervals may not significantly affect donor lung function.
METHODS: Three mechanical hypoventilation conditions were used for three agonal periods, which were defined as the interval between the start of hypoventilation and the time when systolic arterial blood pressure reached < 50 mmHg, i.e., < 10, 30-60, and 150-200 min for very short (VS), short (S), and long (L) groups (n = 5 rats/group). After flushing the lung, heart-lung blocks were reperfused ex vivo for 120 min; physiological data were obtained throughout the reperfusion process.
RESULTS: Pulmonary vascular resistance was significantly higher throughout reperfusion in group L than in the other two groups (p < 0.05). After reperfusion, oxygenation was worse and pulmonary edema was more severe in group L than in group S (p < 0.05). Potassium concentrations in the perfusates were significantly higher in group L than in group VS. Histological analysis revealed more severe injury in group L than in the other two groups.
CONCLUSIONS: Long agonal periods may lead to deterioration of donor lung function; short intervals may not significantly affect donor lung function.