Lung Transplantation, Pulmonary Endothelial Inflammation, and Ex-Situ Lung Perfusion: A Review

Forgie, Keir A.; Fialka, Nicholas; Freed, Darren H.; Nagendran, Jayan

doi:10.3390/cells10061417

Open AccessReview

Lung Transplantation, Pulmonary Endothelial Inflammation, and Ex-Situ Lung Perfusion: A Review

¹

Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB T6G 2B7, Canada

²

Mazankowski Alberta Heart Institute, Edmonton, AB T6G 2B7, Canada

³

Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada

⁴

Alberta Transplant Institute, Edmonton, AB T6G 2E1, Canada

⁵

Canadian Donation and Transplantation Research Program, Edmonton, AB T6G 2E1, Canada

^*

Author to whom correspondence should be addressed.

Cells 2021, 10(6), 1417; https://doi.org/10.3390/cells10061417

Submission received: 3 May 2021 / Revised: 1 June 2021 / Accepted: 2 June 2021 / Published: 7 June 2021

(This article belongs to the Collection The Endothelial Cell in Lung Inflammation)

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Abstract

Lung transplantation (LTx) is the gold standard treatment for end-stage lung disease; however, waitlist mortality remains high due to a shortage of suitable donor lungs. Organ quality can be compromised by lung ischemic reperfusion injury (LIRI). LIRI causes pulmonary endothelial inflammation and may lead to primary graft dysfunction (PGD). PGD is a significant cause of morbidity and mortality post-LTx. Research into preservation strategies that decrease the risk of LIRI and PGD is needed, and ex-situ lung perfusion (ESLP) is the foremost technological advancement in this field. This review addresses three major topics in the field of LTx: first, we review the clinical manifestation of LIRI post-LTx; second, we discuss the pathophysiology of LIRI that leads to pulmonary endothelial inflammation and PGD; and third, we present the role of ESLP as a therapeutic vehicle to mitigate this physiologic insult, increase the rates of donor organ utilization, and improve patient outcomes.

Keywords: lung transplantation; ischemic reperfusion injury; pulmonary inflammation; primary graft dysfunction; ex-situ lung perfusion

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MDPI and ACS Style

Forgie, K.A.; Fialka, N.; Freed, D.H.; Nagendran, J. Lung Transplantation, Pulmonary Endothelial Inflammation, and Ex-Situ Lung Perfusion: A Review. Cells 2021, 10, 1417. https://doi.org/10.3390/cells10061417

AMA Style

Forgie KA, Fialka N, Freed DH, Nagendran J. Lung Transplantation, Pulmonary Endothelial Inflammation, and Ex-Situ Lung Perfusion: A Review. Cells. 2021; 10(6):1417. https://doi.org/10.3390/cells10061417

Chicago/Turabian Style

Forgie, Keir A., Nicholas Fialka, Darren H. Freed, and Jayan Nagendran. 2021. "Lung Transplantation, Pulmonary Endothelial Inflammation, and Ex-Situ Lung Perfusion: A Review" Cells 10, no. 6: 1417. https://doi.org/10.3390/cells10061417

APA Style

Forgie, K. A., Fialka, N., Freed, D. H., & Nagendran, J. (2021). Lung Transplantation, Pulmonary Endothelial Inflammation, and Ex-Situ Lung Perfusion: A Review. Cells, 10(6), 1417. https://doi.org/10.3390/cells10061417

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Lung Transplantation, Pulmonary Endothelial Inflammation, and Ex-Situ Lung Perfusion: A Review

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