Profiling inflammation and tissue injury markers in perfusate and bronchoalveolar lavage fluid during human ex vivo lung perfusion

Andreasson, Anders, Karamanou, Danai, Gillespie, Colin, Özalp, Faruk, Butt, Tanveer, Hill, Paul, Jiwa, Kasim, Walden, Hannah, Green, Nicola, Borthwick, Lee, Clark, Stephen, Pauli, Henning, Gould, Kate, Corris, Paul, Ali, Simi, Dark, John and Fisher, Andrew (2016) Profiling inflammation and tissue injury markers in perfusate and bronchoalveolar lavage fluid during human ex vivo lung perfusion. European Journal of Cardio-Thoracic Surgery, 51 (2). pp. 577-586. ISSN 1010-7940

[img]
Preview
Text (Article)
ezw358.pdf - Published Version
Available under License Creative Commons Attribution Non-commercial 4.0.

Download (1MB) | Preview
Official URL: https://doi.org/10.1093/ejcts/ezw358

Abstract

OBJECTIVES: Availability of donor lungs suitable for transplant falls short of current demand and contributes to waiting list mortality.
Ex vivo lung perfusion (EVLP) offers the opportunity to objectively assess and recondition organs unsuitable for immediate transplant.
Identifying robust biomarkers that can stratify donor lungs during EVLP to use or non-use or for specific interventions could further improve its clinical impact.
METHODS: In this pilot study, 16 consecutive donor lungs unsuitable for immediate transplant were assessed by EVLP. Key inflammatory mediators and tissue injury markers were measured in serial perfusate samples collected hourly and in bronchoalveolar lavage fluid (BALF) collected before and after EVLP. Levels were compared between donor lungs that met criteria for transplant and those that did not.
RESULTS: Seven of the 16 donor lungs (44%) improved during EVLP and were transplanted with uniformly good outcomes. Tissue and vascular injury markers lactate dehydrogenase, HMGB-1 and Syndecan-1 were significantly lower in perfusate from transplanted lungs. A model combining IL-1b and IL-8 concentrations in perfusate could predict final EVLP outcome after 2 h assessment. In addition, perfusate IL-1b concentrations showed an inverse correlation to recipient oxygenation 24 h post-transplant.
CONCLUSIONS: This study confirms the feasibility of using inflammation and tissue injury markers in perfusate and BALF to identify donor lungs most likely to improve for successful transplant during clinical EVLP. These results support examining this issue in a larger study.

Item Type: Article
Uncontrolled Keywords: lung transplant , EVLP, lung injury, inflammation, biomarkers
Subjects: A900 Others in Medicine and Dentistry
C900 Others in Biological Sciences
Department: Faculties > Health and Life Sciences > Psychology
Depositing User: Ay Okpokam
Date Deposited: 21 Mar 2017 12:47
Last Modified: 24 Oct 2017 11:31
URI: http://nrl.northumbria.ac.uk/id/eprint/30138

Actions (login required)

View Item View Item

Downloads

Downloads per month over past year

View more statistics


Policies: NRL Policies | NRL University Deposit Policy | NRL Deposit Licence