Donor Preconditioning with Inhaled Sevoflurane Mitigates the Effects of Ischemia-Reperfusion Injury in a Swine Model of Lung Transplantation.
Alessandro BertaniVitale MiceliLavinia De MonteGiovanna OcchipintiValeria PaganoRosa LiottaEster BadamiFabio TuzzolinoAntonio ArcadipanePublished in: BioMed research international (2021)
Primary graft dysfunction (PGD) and ischemia-reperfusion injury (IRI) occur in up to 30% of patients undergoing lung transplantation and may impact on the clinical outcome. Several strategies for the prevention and treatment of PGD have been proposed, but with limited use in clinical practice. In this study, we investigate the potential application of sevoflurane (SEV) preconditioning to mitigate IRI after lung transplantation. The study included two groups of swines (preconditioned and not preconditioned with SEV) undergoing left lung transplantation after 24-hour of cold ischemia. Recipients' data was collected for 6 hours after reperfusion. Outcome analysis included assessment of ventilatory, hemodynamic, and hemogasanalytic parameters, evaluation of cellularity and cytokines in BAL samples, and histological analysis of tissue samples. Hemogasanalytic, hemodynamic, and respiratory parameters were significantly favorable, and the histological score showed less inflammatory and fibrotic injury in animals receiving SEV treatment. BAL cellular and cytokine profiling showed an anti-inflammatory pattern in animals receiving SEV compared to controls. In a swine model of lung transplantation after prolonged cold ischemia, SEV showed to mitigate the adverse effects of ischemia/reperfusion and to improve animal survival. Given the low cost and easy applicability, the administration of SEV in lung donors may be more extensively explored in clinical practice.
Keyphrases
- ischemia reperfusion injury
- extracorporeal membrane oxygenation
- clinical practice
- patients undergoing
- oxidative stress
- low cost
- cerebral ischemia
- anti inflammatory
- blood pressure
- acute myocardial infarction
- cystic fibrosis
- heart failure
- kidney transplantation
- electronic health record
- coronary artery disease
- radiation therapy
- acute coronary syndrome
- combination therapy
- brain injury
- left ventricular
- human health
- respiratory tract
- acute ischemic stroke