Warm retrograde perfusion can remove more fat from lung grafts with fat embolism in a porcine model

Masahiro Irie, Shinji Otani, Takeshi Kurosaki, Shin Tanaka, Takashi Ohki, Kentaroh Miyoshi, Seiichiro Sugimoto, Masaomi Yamane, Takahiro Oto, Shinichi Toyooka

Research output: Contribution to journalArticle

Abstract

Objective: In lung transplantation, unexpected pulmonary emboli, including thrombi and fat, have been observed with high probability and are associated with potential primary graft dysfunction. We evaluated a new perfusion method using warm retrograde flushing that removes more fat than conventional cold retrograde flushing. Methods: We developed a novel porcine donor model for pulmonary fat embolism by administering autologous fat in the left pulmonary artery. The left pulmonary artery and the left superior and inferior pulmonary veins were cannulated for flushing and collecting these solutions. After flushing, the left lung was reperfused under observation for 3 h. Two groups underwent warm and cold additional retrograde flush (WS; warm solution group, CS; cold solution group). Results: The fat removal rate in the antegrade flush was equal in both groups (3.0 ± 0.6% vs 3.0 ± 0.4%, p = 0.46); however, the rate was significantly greater in the WS group in retrograde flush (25.2 ± 3.2% vs 8.0 ± 1.4%, p = 0.01). Histology with Oil Red O staining and its software analysis showed more residual fat in the CS group (0.12 ± 0.01% vs 0.38 ± 0.07%, p = 0.01). There was no significant difference in the pulmonary function and hemodynamics during the 3-h period after reperfusion. Conclusion: Warm retrograde perfusion can remove more fat from lung grafts with fat embolism in a porcine donor model.

Original languageEnglish
JournalGeneral Thoracic and Cardiovascular Surgery
DOIs
Publication statusAccepted/In press - Jan 1 2019

Fingerprint

Fat Embolism
Swine
Perfusion
Fats
Transplants
Lung
Pulmonary Artery
Primary Graft Dysfunction
Lung Transplantation
Pulmonary Veins
Embolism
Pulmonary Embolism
Reperfusion
Histology
Thrombosis
Software
Hemodynamics
Observation
Staining and Labeling

Keywords

  • Fat embolism
  • Lung
  • Organ donor management
  • Transplantation

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

@article{d5493dbc6af94c1abeeaf24fc80d7392,
title = "Warm retrograde perfusion can remove more fat from lung grafts with fat embolism in a porcine model",
abstract = "Objective: In lung transplantation, unexpected pulmonary emboli, including thrombi and fat, have been observed with high probability and are associated with potential primary graft dysfunction. We evaluated a new perfusion method using warm retrograde flushing that removes more fat than conventional cold retrograde flushing. Methods: We developed a novel porcine donor model for pulmonary fat embolism by administering autologous fat in the left pulmonary artery. The left pulmonary artery and the left superior and inferior pulmonary veins were cannulated for flushing and collecting these solutions. After flushing, the left lung was reperfused under observation for 3 h. Two groups underwent warm and cold additional retrograde flush (WS; warm solution group, CS; cold solution group). Results: The fat removal rate in the antegrade flush was equal in both groups (3.0 ± 0.6{\%} vs 3.0 ± 0.4{\%}, p = 0.46); however, the rate was significantly greater in the WS group in retrograde flush (25.2 ± 3.2{\%} vs 8.0 ± 1.4{\%}, p = 0.01). Histology with Oil Red O staining and its software analysis showed more residual fat in the CS group (0.12 ± 0.01{\%} vs 0.38 ± 0.07{\%}, p = 0.01). There was no significant difference in the pulmonary function and hemodynamics during the 3-h period after reperfusion. Conclusion: Warm retrograde perfusion can remove more fat from lung grafts with fat embolism in a porcine donor model.",
keywords = "Fat embolism, Lung, Organ donor management, Transplantation",
author = "Masahiro Irie and Shinji Otani and Takeshi Kurosaki and Shin Tanaka and Takashi Ohki and Kentaroh Miyoshi and Seiichiro Sugimoto and Masaomi Yamane and Takahiro Oto and Shinichi Toyooka",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s11748-019-01245-w",
language = "English",
journal = "General Thoracic and Cardiovascular Surgery",
issn = "1863-6705",
publisher = "Springer Japan",

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T1 - Warm retrograde perfusion can remove more fat from lung grafts with fat embolism in a porcine model

AU - Irie, Masahiro

AU - Otani, Shinji

AU - Kurosaki, Takeshi

AU - Tanaka, Shin

AU - Ohki, Takashi

AU - Miyoshi, Kentaroh

AU - Sugimoto, Seiichiro

AU - Yamane, Masaomi

AU - Oto, Takahiro

AU - Toyooka, Shinichi

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: In lung transplantation, unexpected pulmonary emboli, including thrombi and fat, have been observed with high probability and are associated with potential primary graft dysfunction. We evaluated a new perfusion method using warm retrograde flushing that removes more fat than conventional cold retrograde flushing. Methods: We developed a novel porcine donor model for pulmonary fat embolism by administering autologous fat in the left pulmonary artery. The left pulmonary artery and the left superior and inferior pulmonary veins were cannulated for flushing and collecting these solutions. After flushing, the left lung was reperfused under observation for 3 h. Two groups underwent warm and cold additional retrograde flush (WS; warm solution group, CS; cold solution group). Results: The fat removal rate in the antegrade flush was equal in both groups (3.0 ± 0.6% vs 3.0 ± 0.4%, p = 0.46); however, the rate was significantly greater in the WS group in retrograde flush (25.2 ± 3.2% vs 8.0 ± 1.4%, p = 0.01). Histology with Oil Red O staining and its software analysis showed more residual fat in the CS group (0.12 ± 0.01% vs 0.38 ± 0.07%, p = 0.01). There was no significant difference in the pulmonary function and hemodynamics during the 3-h period after reperfusion. Conclusion: Warm retrograde perfusion can remove more fat from lung grafts with fat embolism in a porcine donor model.

AB - Objective: In lung transplantation, unexpected pulmonary emboli, including thrombi and fat, have been observed with high probability and are associated with potential primary graft dysfunction. We evaluated a new perfusion method using warm retrograde flushing that removes more fat than conventional cold retrograde flushing. Methods: We developed a novel porcine donor model for pulmonary fat embolism by administering autologous fat in the left pulmonary artery. The left pulmonary artery and the left superior and inferior pulmonary veins were cannulated for flushing and collecting these solutions. After flushing, the left lung was reperfused under observation for 3 h. Two groups underwent warm and cold additional retrograde flush (WS; warm solution group, CS; cold solution group). Results: The fat removal rate in the antegrade flush was equal in both groups (3.0 ± 0.6% vs 3.0 ± 0.4%, p = 0.46); however, the rate was significantly greater in the WS group in retrograde flush (25.2 ± 3.2% vs 8.0 ± 1.4%, p = 0.01). Histology with Oil Red O staining and its software analysis showed more residual fat in the CS group (0.12 ± 0.01% vs 0.38 ± 0.07%, p = 0.01). There was no significant difference in the pulmonary function and hemodynamics during the 3-h period after reperfusion. Conclusion: Warm retrograde perfusion can remove more fat from lung grafts with fat embolism in a porcine donor model.

KW - Fat embolism

KW - Lung

KW - Organ donor management

KW - Transplantation

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