TY - JOUR
T1 - Prolonged warm ischemia exacerbated acute rejection after lung transplantation from donation after cardiac death in a mouse
AU - Hirano, Yutaka
AU - Sugimoto, Seiichiro
AU - Yamamoto, Sumiharu
AU - Okada, Masanori
AU - Otani, Shinji
AU - Ohara, Toshiaki
AU - Yamane, Masaomi
AU - Matsukawa, Akihiro
AU - Oto, Takahiro
AU - Toyooka, Shinichi
N1 - Funding Information:
This study was supported by a Grant-in-Aid for Scientific Research, Grant no. 24791461, from the Japan Society for the Promotion of Science and JSPS Fujita Memorial Fund for Medical Research.
Publisher Copyright:
© 2019, The Japanese Association for Thoracic Surgery.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Objective: In lung transplantation (LTx) from donation after cardiac death (DCD), the donor lungs are inevitably exposed to warm ischemic time (WIT) between the cardiac arrest and the initiation of cold preservation. We conducted this study to examine the effect of prolonged WIT on lung allograft rejection in a murine model of LTx from DCD. Methods: Allogeneic BALB/c → B6 LTx from DCD was performed with a WIT of 15 min (WIT15 group, n = 5) or 60 min (WIT60 group, n = 5). Recipients were immunosuppressed by perioperative costimulatory blockade. The lung allografts were analyzed by histology and flow cytometry on day 7 after the LTx. Results: Histologically, the rejection grade in the WIT60 group was significantly higher than that in the WIT15 group (3.4 ± 0.4 vs. 2.2 ± 0.2, P = 0.0278). Moreover, the intragraft CD8+ to CD4+ T cell ratio in the WIT60 group was significantly higher than that in the WIT15 group (2.3 ± 0.12 vs. 1.2 ± 0.11, P < 0.0001). Conclusions: Prolonged WIT could exacerbate the severity of lung allograft rejection after LTx from DCD. Minimization of the WIT could improve the outcomes after LTx from DCD.
AB - Objective: In lung transplantation (LTx) from donation after cardiac death (DCD), the donor lungs are inevitably exposed to warm ischemic time (WIT) between the cardiac arrest and the initiation of cold preservation. We conducted this study to examine the effect of prolonged WIT on lung allograft rejection in a murine model of LTx from DCD. Methods: Allogeneic BALB/c → B6 LTx from DCD was performed with a WIT of 15 min (WIT15 group, n = 5) or 60 min (WIT60 group, n = 5). Recipients were immunosuppressed by perioperative costimulatory blockade. The lung allografts were analyzed by histology and flow cytometry on day 7 after the LTx. Results: Histologically, the rejection grade in the WIT60 group was significantly higher than that in the WIT15 group (3.4 ± 0.4 vs. 2.2 ± 0.2, P = 0.0278). Moreover, the intragraft CD8+ to CD4+ T cell ratio in the WIT60 group was significantly higher than that in the WIT15 group (2.3 ± 0.12 vs. 1.2 ± 0.11, P < 0.0001). Conclusions: Prolonged WIT could exacerbate the severity of lung allograft rejection after LTx from DCD. Minimization of the WIT could improve the outcomes after LTx from DCD.
KW - Brain dead donor
KW - Donation after cardiac death
KW - Lung transplantation
KW - Organ preservation
KW - Rejection
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U2 - 10.1007/s11748-019-01181-9
DO - 10.1007/s11748-019-01181-9
M3 - Article
C2 - 31367969
AN - SCOPUS:85070059861
SN - 1863-6705
VL - 68
SP - 57
EP - 62
JO - General Thoracic and Cardiovascular Surgery
JF - General Thoracic and Cardiovascular Surgery
IS - 1
ER -