Universität zu Köln

Herrmann, Gudrun, Knudsen, Lars ORCID: 0000-0002-7926-3879, Madershahian, Navid, Muehlfeld, Christian, Frank, Konrad, Rahmanian, Parwis, Wahlers, Thorsten, Wittwer, Thorsten and Ochs, Matthias (2014). Effects of exogenous surfactant on the non-heart-beating donor lung graft in experimental lung transplantation - a stereological study. J. Anat., 224 (5). S. 594 - 603. HOBOKEN: WILEY-BLACKWELL. ISSN 1469-7580

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Abstract

The use of non-heart-beating donor (NHBD) lungs may help to overcome the shortage of lung grafts in clinical lung transplantation, but warm ischaemia and ischaemia/reperfusion injury (I/R injury) resulting in primary graft dysfunction represent a considerable threat. Thus, better strategies for optimized preservation of lung grafts are urgently needed. Surfactant dysfunction has been shown to contribute to I/R injury, and surfactant replacement therapy is effective in enhancing lung function and structural integrity in related rat models. In the present study we hypothesize that surfactant replacement therapy reduces oedema formation in a pig model of NHBD lung transplantation. Oedema formation was quantified with (SF) and without (non-SF) surfactant replacement therapy in interstitial and alveolar compartments by means of design-based stereology in NHBD lungs 7 h after cardiac arrest, reperfusion and transplantation. A sham-operated group served as control. In both NHBD groups, nearly all animals died within the first hours after transplantation due to right heart failure. Both SF and non-SF developed an interstitial oedema of similar degree, as shown by an increase in septal wall volume and arithmetic mean thickness as well as an increase in the volume of peribron-chovascular connective tissue. Regarding intra-alveolar oedema, no statistically significant difference could be found between SF and non-SF. In conclusion, surfactant replacement therapy cannot prevent poor outcome after prolonged warm ischaemia of 7 h in this model. While the beneficial effects of surfactant replacement therapy have been observed in several experimental and clinical studies related to heart-beating donor lungs and cold ischaemia, it is unlikely that surfactant replacement therapy will overcome the shortage of organs in the context of prolonged warm ischaemia, for example, 7 h. Moreover, our data demonstrate that right heart function and dysfunctions of the pulmonary vascular bed are limiting factors that need to be addressed in NHBD.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Herrmann, Gudrun UNSPECIFIED UNSPECIFIED UNSPECIFIED Knudsen, Lars UNSPECIFIED orcid.org/0000-0002-7926-3879 UNSPECIFIED Madershahian, Navid UNSPECIFIED UNSPECIFIED UNSPECIFIED Muehlfeld, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Frank, Konrad UNSPECIFIED UNSPECIFIED UNSPECIFIED Rahmanian, Parwis UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Wittwer, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Ochs, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-439725
DOI:	10.1111/joa.12167
Journal or Publication Title:	J. Anat.
Volume:	224
Number:	5
Page Range:	S. 594 - 603
Date:	2014
Publisher:	WILEY-BLACKWELL
Place of Publication:	HOBOKEN
ISSN:	1469-7580
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ISCHEMIA-REPERFUSION INJURY; PULMONARY SURFACTANT; ISCHEMIA/REPERFUSION INJURY; INTRAALVEOLAR SURFACTANT; EDEMA FORMATION; PRESERVATION; MODEL; RAT; RETROGRADE; SURVIVAL Multiple languages Anatomy & Morphology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/43972