Xenogeneic cross-circulation for extracorporeal recovery of injured human lungs.

Autor: Hozain AE; Department of Biomedical Engineering, Columbia University, New York, NY, USA.; Department of Surgery, Columbia University Medical Center, Columbia University, New York, NY, USA., O'Neill JD; Department of Biomedical Engineering, Columbia University, New York, NY, USA., Pinezich MR; Department of Biomedical Engineering, Columbia University, New York, NY, USA., Tipograf Y; Department of Surgery, Columbia University Medical Center, Columbia University, New York, NY, USA., Donocoff R; Institute of Comparative Medicine, Columbia University Medical Center, Columbia University, New York, NY, USA., Cunningham KM; Department of Biomedical Engineering, Columbia University, New York, NY, USA., Tumen A; Department of Thoracic Surgery, Vanderbilt University, Nashville, TN, USA., Fung K; Department of Clinical Perfusion, Columbia University Medical Center, Columbia University, New York, NY, USA., Ukita R; Department of Thoracic Surgery, Vanderbilt University, Nashville, TN, USA., Simpson MT; Department of Surgery, Columbia University Medical Center, Columbia University, New York, NY, USA., Reimer JA; Department of Biomedical Engineering, Columbia University, New York, NY, USA.; Department of Surgery, Columbia University Medical Center, Columbia University, New York, NY, USA., Ruiz EC; Department of Biomedical Engineering, Columbia University, New York, NY, USA., Queen D; Vagelos College of Physicians and Surgeons, Columbia University Medical Center, Columbia University, New York, NY, USA., Stokes JW; Department of Thoracic Surgery, Vanderbilt University, Nashville, TN, USA., Cardwell NL; Department of Thoracic Surgery, Vanderbilt University, Nashville, TN, USA., Talackine J; Department of Thoracic Surgery, Vanderbilt University, Nashville, TN, USA., Kim J; Department of Biomedical Engineering, Columbia University, New York, NY, USA.; Department of Biomedical Engineering, Stevens Institute of Technology, Hoboken, NJ, USA., Snoeck HW; Department of Medicine, Columbia University Medical Center, Columbia University, New York, NY, USA.; Department of Microbiology and Immunology, Columbia University Medical Center, Columbia University, New York, NY, USA.; Columbia Center for Human Development, Columbia University Medical Center, Columbia University, New York, NY, USA., Chen YW; Department of Medicine, Columbia University Medical Center, Columbia University, New York, NY, USA.; Department of Medicine, University of Southern California, Los Angeles, CA, USA.; Department of Stem Cell Biology and Regenerative Medicine, University of Southern California, Los Angeles, CA, USA., Romanov A; Institute of Comparative Medicine, Columbia University Medical Center, Columbia University, New York, NY, USA., Marboe CC; Department of Pathology and Cell Biology, Columbia University Medical Center, Columbia University, New York, NY, USA., Griesemer AD; Department of Surgery, Columbia University Medical Center, Columbia University, New York, NY, USA.; Center for Translational Immunology, Columbia University Medical Center, Columbia University, New York, NY, USA., Guenthart BA; Department of Biomedical Engineering, Columbia University, New York, NY, USA.; Department of Cardiothoracic Surgery, Stanford University, Stanford, CA, USA., Bacchetta M; Department of Biomedical Engineering, Columbia University, New York, NY, USA. matthew.bacchetta@vumc.org.; Department of Thoracic Surgery, Vanderbilt University, Nashville, TN, USA. matthew.bacchetta@vumc.org.; Department of Cardiac Surgery, Vanderbilt University, Nashville, TN, USA. matthew.bacchetta@vumc.org.; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA. matthew.bacchetta@vumc.org.; Departments of Thoracic Surgery and Cardiac Surgery, Vanderbilt University, Nashville, TN, USA. matthew.bacchetta@vumc.org., Vunjak-Novakovic G; Department of Biomedical Engineering, Columbia University, New York, NY, USA. gv2131@columbia.edu.; Department of Medicine, Columbia University Medical Center, Columbia University, New York, NY, USA. gv2131@columbia.edu.
Jazyk: angličtina
Zdroj: Nature medicine [Nat Med] 2020 Jul; Vol. 26 (7), pp. 1102-1113. Date of Electronic Publication: 2020 Jul 13.
DOI: 10.1038/s41591-020-0971-8
Abstrakt: Patients awaiting lung transplantation face high wait-list mortality, as injury precludes the use of most donor lungs. Although ex vivo lung perfusion (EVLP) is able to recover marginal quality donor lungs, extension of normothermic support beyond 6 h has been challenging. Here we demonstrate that acutely injured human lungs declined for transplantation, including a lung that failed to recover on EVLP, can be recovered by cross-circulation of whole blood between explanted human lungs and a Yorkshire swine. This xenogeneic platform provided explanted human lungs a supportive, physiologic milieu and systemic regulation that resulted in functional and histological recovery after 24 h of normothermic support. Our findings suggest that cross-circulation can serve as a complementary approach to clinical EVLP to recover injured donor lungs that could not otherwise be utilized for transplantation, as well as a translational research platform for immunomodulation and advanced organ bioengineering.
Databáze: MEDLINE