Does perfusion with the organ care system influence inflammatory response in lung transplantation?
| Autor: | Mohamed Amrani, Aron-Frederik Popov, Paras Dalal, Martin Carby, Toufan Bahrami, Anna Reed, Nandor Marczin, Andre R. Simon, Fabio De Robertis, Shirin Sheibani, Rosalba Romano, Simona Soresi, Louit Thakuria |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
biology business.industry medicine.medical_treatment Primary Graft Dysfunction Lung injury medicine.disease_cause Gastroenterology Neutrophilia Transplantation Myeloperoxidase Internal medicine Immunology biology.protein medicine Lung transplantation medicine.symptom business Perfusion Oxidative stress |
| Zdroj: | 8.2 Transplantation. |
| Popis: | Introduction. The Organ Care System (OCS) is a sophisticated platform to preserve, evaluate and recondition donated lungs for transplantation (LTx). The impact of OCS on inflammatory response is not known. Here we focus on leukocyte responses and release of neutrophil-derived permeability and oxidative stress mediators. Methods. Neutrophil kinetics were retrospectively evaluated in 269 patients receiving standard-LTx (n=248) or OCS-LTx (n=21) between 2010 and 2015. In a subset of 40 patients, plasma levels of Myeloperoxidase (MPO) and Heparin Binding Protein (HBP) were measured by ELISA at baseline and at 0, 6, 12, 24, 48, and 72 hours. Results. Total leukocyte and neutrophil counts and CRP levels were significantly lower in the OCS group on day 1 and 2. Figure 1 shows plasma levels of HBP and MPO demonstrating lower mediator release at several time points in the OCS group. Postoperative gas exchange, duration of ventilation, ITU and hospital stay were similar between groups. Patient with severe grade3 Primary Graft Dysfunction (PGD) had higher HBP at T0 after LTx compared to patients with no PGD (p= 0.038). Conclusions. Recipients of OCS lungs exhibit lower leucocytosis and neutrophilia and lesser inflammatory mediator release with similar clinical outcomes compared to standard LTx. PGD is associated with increased HBP release suggesting HBP as a potential biomarker of lung injury. |
| Databáze: | OpenAIRE |
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