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Article

Functional, Metabolic and Morphologic Results of Ex Vivo Donor Lung Perfusion with a Perfluorocarbon-Based Oxygen Carrier Nanoemulsion in a Large Animal Transplantation Model

1
Department of Thoracic Surgery, University Hospital Zurich–University of Zurich, CH-8091 Zurich, Switzerland
2
Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, CH-8057 Zurich, Switzerland
3
Department of Surgical Research, University Hospital Zurich–University of Zurich, CH-8091 Zurich, Switzerland
4
Institute of Radiology, University Hospital Zurich–University of Zurich, CH-8091 Zurich, Switzerland
5
Institute Charles Sadron, CNRS, University of Strasbourg, 67200 Strasbourg, France
6
Institute of Anesthesiology, University Hospital Zurich-University of Zurich, CH-8091 Zurich, Switzerland
*
Author to whom correspondence should be addressed.
Cells 2020, 9(11), 2501; https://doi.org/10.3390/cells9112501
Received: 1 October 2020 / Revised: 6 November 2020 / Accepted: 9 November 2020 / Published: 18 November 2020
(This article belongs to the Special Issue Immuno-Pathology in Organ and Cell Transplantation)
Background: Ex vivo lung perfusion (EVLP) is a technology that allows the re-evaluation of questionable donor lung before implantation and it has the potential to repair injured donor lungs that are otherwise unsuitable for transplantation. We hypothesized that perfluorocarbon-based oxygen carrier, a novel reconditioning strategy instilled during EVLP would improve graft function. Methods: We utilized perfluorocarbon-based oxygen carrier (PFCOC) during EVLP to recondition and improve lung graft function in a pig model of EVLP and lung transplantation. Lungs were retrieved and stored for 24 h at 4 °C. EVLP was done for 6 h with or without PFCOC. In the transplantation groups, left lung transplantation was done after EVLP with or without PFCOC. Allograft function was assessed by means of pulmonary gas exchange, lung mechanics and vascular pressures, histology and transmission electron microscopy (TEM). Results: In the EVLP only groups, physiological and biochemical markers during the 6-h perfusion period were comparable. However, perfusate lactate potassium levels were lower and ATP levels were higher in the PFCOC group. Radiologic assessment revealed significantly more lung infiltrates in the controls than in the PFCOC group (p = 0.04). In transplantation groups, perfusate glucose consumption was higher in the control group. Lactate levels were significantly lower in the PFCOC group (p = 0.02). Perfusate flavin mononucleotide (FMN) was significantly higher in the controls (p = 0.008). Post-transplant gas exchange was significantly better during the 4-h reperfusion period in the PFCOC group (p = 0.01). Plasma IL-8 and IL-12 levels were significantly lower in the PFCOC group (p = 0.01, p = 0.03, respectively). ATP lung tissue levels at the end of the transplantation were higher and myeloperoxidase (MPO) levels in lung tissue were lower in the PFCOC group compared to the control group. In the PFCOC group, TEM showed better tissue preservation and cellular viability. Conclusion: PFCOC application is safe during EVLP in lungs preserved 24 h at 4 °C. Although this strategy did not significantly affect the EVLP physiology, metabolic markers of the donor quality such as lactate production, glucose consumption, neutrophil infiltration and preservation of mitochondrial function were better in the PFCOC group. Following transplantation, PFCOC resulted in better graft function and TEM showed better tissue preservation, cellular viability and improved gas transport. View Full-Text
Keywords: ex vivo lung perfusion; oxygen carrier; perfluorocarbon; lung transplantation ex vivo lung perfusion; oxygen carrier; perfluorocarbon; lung transplantation
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MDPI and ACS Style

Inci, I.; Arni, S.; Iskender, I.; Citak, N.; Rodriguez, J.M.; Weisskopf, M.; Opitz, I.; Weder, W.; Frauenfelder, T.; Krafft, M.P.; Spahn, D.R. Functional, Metabolic and Morphologic Results of Ex Vivo Donor Lung Perfusion with a Perfluorocarbon-Based Oxygen Carrier Nanoemulsion in a Large Animal Transplantation Model. Cells 2020, 9, 2501. https://doi.org/10.3390/cells9112501

AMA Style

Inci I, Arni S, Iskender I, Citak N, Rodriguez JM, Weisskopf M, Opitz I, Weder W, Frauenfelder T, Krafft MP, Spahn DR. Functional, Metabolic and Morphologic Results of Ex Vivo Donor Lung Perfusion with a Perfluorocarbon-Based Oxygen Carrier Nanoemulsion in a Large Animal Transplantation Model. Cells. 2020; 9(11):2501. https://doi.org/10.3390/cells9112501

Chicago/Turabian Style

Inci, Ilhan, Stephan Arni, Ilker Iskender, Necati Citak, Josep M. Rodriguez, Miriam Weisskopf, Isabelle Opitz, Walter Weder, Thomas Frauenfelder, Marie P. Krafft, and Donat R. Spahn. 2020. "Functional, Metabolic and Morphologic Results of Ex Vivo Donor Lung Perfusion with a Perfluorocarbon-Based Oxygen Carrier Nanoemulsion in a Large Animal Transplantation Model" Cells 9, no. 11: 2501. https://doi.org/10.3390/cells9112501

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