Argon and xenon ventilation during prolonged ex vivo lung perfusion

作者：Martens An; Montoli Matteo; Faggi Giulio; Katz Ira; Pype Jan; Vanaudenaerde Bart M; Van Raemdonck Dirk E M; Neyrinck Arne P

来源：Journal of Surgical Research, 2016, 201(1): 44-52.

DOI：10.1016/j.jss.2015.10.007

• Lung transplantation
• Ischemia reperfusion injury
• Ex vivo lung perfusion
• Noble gases
• Argon
• Xenon

Background: Evidence supports the use of ex vivo lung perfusion (EVLP) as a platform for active reconditioning before transplantation to increase the potential donor pool and to reduce the incidence of primary graft dysfunction. A promising reconditioning strategy is the administration of inhaled noble gases based on their organoprotective effects. Our aim was to validate a porcine warm ischemic lung injury model and investigate post-conditioning with argon (Ar) or xenon (Xe) during prolonged EVLP.
Methods: Domestic pigs were divided in four groups (n = 5 per group). In the negative control group, lungs were flushed immediately. In the positive control (PC) and treatment (Ar, Xe) groups, lungs were flushed after a warm ischemic interval of 2-h in situ. All grafts were evaluated and treated during normothermic EVLP for 6 h. In the control groups, lungs were ventilated with 70% N-2/30% O-2 and in the treatment groups with 70% Ar/30% O-2 or 70% Xe/30% O-2, respectively. Outcome parameters were physiological variables (pulmonary vascular resistance, peak airway pressures, and PaO2/FiO(2)), histology, wet-to-dry weight ratio, bronchoalveolar lavage, and computed tomography scan.
Results: A significant difference between negative control and PC for pulmonary vascular resistance, peak airway pressures, PaO2/FiO(2), wet-to-dry weight ratio, histology, and computed tomography-imaging was observed. No significant differences between the injury group (PC) and the treatment groups (Ar, Xe) were found.
Conclusions: We validated a reproducible prolonged 6-h EVLP model with 2 h of warm ischemia and described the physiological changes over time. In this model, ventilation during EVLP with Ar or Xe administered postinjury did not improve graft function.

• 出版日期2016-3