Early hemodynamic injury during donor brain death determines the severity of primary graft dysfunction after lung transplantation

被引:73
作者
Avlonitis, V. S. [1 ]
Wigfield, C. H.
Golledge, H. D. R.
Kirby, J. A.
Dark, J. H.
机构
[1] Univ Newcastle Upon Tyne, Sch Surg & Reprod Sci, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England
[2] Univ Newcastle Upon Tyne, Freeman Hosp, Dept Cardiothorac Surg, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England
[3] Univ Newcastle Upon Tyne, Comparat Biol Ctr, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England
基金
英国惠康基金;
关键词
brain death; lung injury; lung transplantation; neurogenic pulmonary edema; primary graft dysfunction; rat;
D O I
10.1111/j.1600-6143.2006.01593.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
Sympathetic discharge and hypertensive crisis often accompany brain death, causing neurogenic pulmonary edema. Progressive systemic inflammatory response develops, which can injure the lung further. We investigated whether (a) early hemodynamic injury during donor brain death increases reperfusion injury after lung transplantation and (b) delaying lung recovery would augment reperfusion injury further, because of the progressive systemic inflammatory response in the donor. Brain death was induced by intracranial balloon inflation in rats, with or without alpha-adrenergic blockade pretreatment to prevent the hypertensive crisis. Another group of rats had a sham procedure. Lungs were retrieved 15 min after brain death or sham procedure and reperfused using recipient rats. In a fourth group, brain death was induced and the lungs were retrieved 5 h after brain death and reperfused. Postreperfusion, lungs retrieved early from untreated brain-dead donors developed more severe reperfusion injury, as assessed by functional parameters and inflammatory markers, than those from sham or alpha-blockade-treated donors. Lungs retrieved late from brain-dead donors had similar inflammatory markers after reperfusion to those retrieved early, but significantly lower pulmonary vascular resistance. Early hemodynamic damage during donor brain death increases reperfusion injury after lung transplantation. Delaying retrieval may allow the lung to recover from the hemodynamic injury.
引用
收藏
页码:83 / 90
页数:8
相关论文
共 29 条
[1]
The hemodynamic mechanisms of lung injury and systemic inflammatory response following brain death in the transplant donor [J].
Avlonitis, VS ;
Wigfield, CH ;
Kirby, JA ;
Dark, JH .
AMERICAN JOURNAL OF TRANSPLANTATION, 2005, 5 (04) :684-693
[2]
Pulmonary transplantation: The role of brain death in donor lung injury. [J].
Avlonitis, VS ;
Fisher, AJ ;
Kirby, JA ;
Dark, JH .
TRANSPLANTATION, 2003, 75 (12) :1928-1933
[3]
Primary graft failure following lung transplantation [J].
Christie, JD ;
Bavaria, JE ;
Palevsky, HI ;
Litzky, L ;
Blumenthal, NP ;
Kaiser, LR ;
Kotloff, RM .
CHEST, 1998, 114 (01) :51-60
[4]
EFFECTS OF AEROSOLIZED METHYLPREDNISOLONE ON EXPERIMENTAL NEUROGENIC PULMONARY INJURY [J].
EDMONDS, HL ;
CANNON, HC ;
GARRETSON, HD ;
DAHLQUIST, G .
NEUROSURGERY, 1986, 19 (01) :36-40
[5]
SHORT-TERM REVERSIBILITY OF ULTRASTRUCTURAL-CHANGES IN PULMONARY CAPILLARIES CAUSED BY STRESS FAILURE [J].
ELLIOTT, AR ;
FU, ZX ;
TSUKIMOTO, K ;
PREDILETTO, R ;
MATHIEUCOSTELLO, O ;
WEST, JB .
JOURNAL OF APPLIED PHYSIOLOGY, 1992, 73 (03) :1150-1158
[6]
Non-immune acute graft injury after lung transplantation and the risk of subsequent bronchiolitis obliterans syndrome (BOS) [J].
Fisher, AJ ;
Wardle, J ;
Dark, JH ;
Corris, PA .
JOURNAL OF HEART AND LUNG TRANSPLANTATION, 2002, 21 (11) :1206-1212
[7]
Elevated levels of interleukin-8 in donor lungs is associated with early craft failure after lung transplantation [J].
Fisher, AJ ;
Donnelly, SC ;
Hirani, N ;
Haslett, C ;
Strieter, RM ;
Dark, JH ;
Corris, PA .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2001, 163 (01) :259-265
[8]
Follette DM, 1998, J HEART LUNG TRANSPL, V17, P423
[9]
Double-lung transplantation in the rat: An acute, syngeneic in situ model [J].
Hausen, B ;
Demertzis, S ;
Schroder, F ;
Beuke, M ;
Schafers, HJ .
ANNALS OF THORACIC SURGERY, 1996, 61 (01) :184-189
[10]
Role of neuropeptide Y and its receptor subtypes in neurogenic pulmonary edema [J].
Hirabayashi, A ;
Nishiwaki, K ;
Shimada, Y ;
Ishikawa, N .
EUROPEAN JOURNAL OF PHARMACOLOGY, 1996, 296 (03) :297-305