Cold ischemia or topical-ECMO for lung preservation: a randomized experimental study
Autor(a) principal: | |
---|---|
Data de Publicação: | 2014 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | São Paulo medical journal (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802014000100028 |
Resumo: | CONTEXT AND OBJECTIVE: Lung preservation remains a challenging issue for lung transplantation groups. Along with the development of ex vivo lung perfusion, a new preservation method known as topical-ECMO (extracorporal membrane oxygenation) has been proposed. The present study compared topical-ECMO with cold ischemia (CI) for lung preservation in an ex vivo experimental model. DESIGN AND SETTING: Randomized experimental study, conducted at a public medical school. METHOD: Fourteen human lungs were retrieved from seven brain-dead donors that were considered unsuitable for transplantation. The lung bloc was divided and each lung was randomized to be preserved by means of topical-ECMO or CI (4-7 °C) for eight hours. These lungs were then reconnected to an ex vivo perfusion system for functional evaluation. Lung biopsies were obtained at three times. The functional variables assessed were oxygenation capacity (OC) and pulmonary artery pressure (PAP); and the histological variables were lung injury score (LIS) and apoptotic cell count (ACC). RESULTS : The mean OC was 468 mmHg (± 81.6) in the topical-ECMO group and 455.8 (± 54) for CI (P = 0.758). The median PAP was 140 mmHg (120-160) in the topical-ECMO group and 140 mmHg (140-150) for CI (P = 0.285). The mean LIS was 35.57 (± 4.5) in the topical-ECMO group and 33.86 (± 6.1) for CI (P = 0.367). The ACC was 25.00 (± 9.34) in the topical-ECMO group and 24.86 (± 10.374) for CI (P = 0.803). CONCLUSIONS: The present study showed that topical-ECMO was not superior to cold ischemia for up to eight hours of lung preservation. |
id |
APM-1_5dd8e7fc54c14f43bc5eaec40b950855 |
---|---|
oai_identifier_str |
oai:scielo:S1516-31802014000100028 |
network_acronym_str |
APM-1 |
network_name_str |
São Paulo medical journal (Online) |
repository_id_str |
|
spelling |
Cold ischemia or topical-ECMO for lung preservation: a randomized experimental studyOrgan preservationReperfusion injuryLung transplantationTransplantation, homologousThoracic surgery CONTEXT AND OBJECTIVE: Lung preservation remains a challenging issue for lung transplantation groups. Along with the development of ex vivo lung perfusion, a new preservation method known as topical-ECMO (extracorporal membrane oxygenation) has been proposed. The present study compared topical-ECMO with cold ischemia (CI) for lung preservation in an ex vivo experimental model. DESIGN AND SETTING: Randomized experimental study, conducted at a public medical school. METHOD: Fourteen human lungs were retrieved from seven brain-dead donors that were considered unsuitable for transplantation. The lung bloc was divided and each lung was randomized to be preserved by means of topical-ECMO or CI (4-7 °C) for eight hours. These lungs were then reconnected to an ex vivo perfusion system for functional evaluation. Lung biopsies were obtained at three times. The functional variables assessed were oxygenation capacity (OC) and pulmonary artery pressure (PAP); and the histological variables were lung injury score (LIS) and apoptotic cell count (ACC). RESULTS : The mean OC was 468 mmHg (± 81.6) in the topical-ECMO group and 455.8 (± 54) for CI (P = 0.758). The median PAP was 140 mmHg (120-160) in the topical-ECMO group and 140 mmHg (140-150) for CI (P = 0.285). The mean LIS was 35.57 (± 4.5) in the topical-ECMO group and 33.86 (± 6.1) for CI (P = 0.367). The ACC was 25.00 (± 9.34) in the topical-ECMO group and 24.86 (± 10.374) for CI (P = 0.803). CONCLUSIONS: The present study showed that topical-ECMO was not superior to cold ischemia for up to eight hours of lung preservation. Associação Paulista de Medicina - APM2014-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802014000100028Sao Paulo Medical Journal v.132 n.1 2014reponame:São Paulo medical journal (Online)instname:Associação Paulista de Medicinainstacron:APM10.1590/1516-3180.2014.1321594info:eu-repo/semantics/openAccessMariani,Alessandro WasumMedeiros,Israel LopesPego-Fernandes,Paulo ManuelFernandes,Flavio GuimaraesUnterpertinguer,Fernando Do ValeFernandes,Lucas MatosCardoso,Paulo FranciscoCanzian,MauroJatene,Fabio Bisceglieng2014-01-24T00:00:00Zoai:scielo:S1516-31802014000100028Revistahttp://www.scielo.br/spmjhttps://old.scielo.br/oai/scielo-oai.phprevistas@apm.org.br1806-94601516-3180opendoar:2014-01-24T00:00São Paulo medical journal (Online) - Associação Paulista de Medicinafalse |
dc.title.none.fl_str_mv |
Cold ischemia or topical-ECMO for lung preservation: a randomized experimental study |
title |
Cold ischemia or topical-ECMO for lung preservation: a randomized experimental study |
spellingShingle |
Cold ischemia or topical-ECMO for lung preservation: a randomized experimental study Mariani,Alessandro Wasum Organ preservation Reperfusion injury Lung transplantation Transplantation, homologous Thoracic surgery |
title_short |
Cold ischemia or topical-ECMO for lung preservation: a randomized experimental study |
title_full |
Cold ischemia or topical-ECMO for lung preservation: a randomized experimental study |
title_fullStr |
Cold ischemia or topical-ECMO for lung preservation: a randomized experimental study |
title_full_unstemmed |
Cold ischemia or topical-ECMO for lung preservation: a randomized experimental study |
title_sort |
Cold ischemia or topical-ECMO for lung preservation: a randomized experimental study |
author |
Mariani,Alessandro Wasum |
author_facet |
Mariani,Alessandro Wasum Medeiros,Israel Lopes Pego-Fernandes,Paulo Manuel Fernandes,Flavio Guimaraes Unterpertinguer,Fernando Do Vale Fernandes,Lucas Matos Cardoso,Paulo Francisco Canzian,Mauro Jatene,Fabio Biscegli |
author_role |
author |
author2 |
Medeiros,Israel Lopes Pego-Fernandes,Paulo Manuel Fernandes,Flavio Guimaraes Unterpertinguer,Fernando Do Vale Fernandes,Lucas Matos Cardoso,Paulo Francisco Canzian,Mauro Jatene,Fabio Biscegli |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
Mariani,Alessandro Wasum Medeiros,Israel Lopes Pego-Fernandes,Paulo Manuel Fernandes,Flavio Guimaraes Unterpertinguer,Fernando Do Vale Fernandes,Lucas Matos Cardoso,Paulo Francisco Canzian,Mauro Jatene,Fabio Biscegli |
dc.subject.por.fl_str_mv |
Organ preservation Reperfusion injury Lung transplantation Transplantation, homologous Thoracic surgery |
topic |
Organ preservation Reperfusion injury Lung transplantation Transplantation, homologous Thoracic surgery |
description |
CONTEXT AND OBJECTIVE: Lung preservation remains a challenging issue for lung transplantation groups. Along with the development of ex vivo lung perfusion, a new preservation method known as topical-ECMO (extracorporal membrane oxygenation) has been proposed. The present study compared topical-ECMO with cold ischemia (CI) for lung preservation in an ex vivo experimental model. DESIGN AND SETTING: Randomized experimental study, conducted at a public medical school. METHOD: Fourteen human lungs were retrieved from seven brain-dead donors that were considered unsuitable for transplantation. The lung bloc was divided and each lung was randomized to be preserved by means of topical-ECMO or CI (4-7 °C) for eight hours. These lungs were then reconnected to an ex vivo perfusion system for functional evaluation. Lung biopsies were obtained at three times. The functional variables assessed were oxygenation capacity (OC) and pulmonary artery pressure (PAP); and the histological variables were lung injury score (LIS) and apoptotic cell count (ACC). RESULTS : The mean OC was 468 mmHg (± 81.6) in the topical-ECMO group and 455.8 (± 54) for CI (P = 0.758). The median PAP was 140 mmHg (120-160) in the topical-ECMO group and 140 mmHg (140-150) for CI (P = 0.285). The mean LIS was 35.57 (± 4.5) in the topical-ECMO group and 33.86 (± 6.1) for CI (P = 0.367). The ACC was 25.00 (± 9.34) in the topical-ECMO group and 24.86 (± 10.374) for CI (P = 0.803). CONCLUSIONS: The present study showed that topical-ECMO was not superior to cold ischemia for up to eight hours of lung preservation. |
publishDate |
2014 |
dc.date.none.fl_str_mv |
2014-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802014000100028 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802014000100028 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/1516-3180.2014.1321594 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
dc.source.none.fl_str_mv |
Sao Paulo Medical Journal v.132 n.1 2014 reponame:São Paulo medical journal (Online) instname:Associação Paulista de Medicina instacron:APM |
instname_str |
Associação Paulista de Medicina |
instacron_str |
APM |
institution |
APM |
reponame_str |
São Paulo medical journal (Online) |
collection |
São Paulo medical journal (Online) |
repository.name.fl_str_mv |
São Paulo medical journal (Online) - Associação Paulista de Medicina |
repository.mail.fl_str_mv |
revistas@apm.org.br |
_version_ |
1754209263881814016 |