Modelo experimental ex vivo com bloco pulmonar dividido

Mariani, Alessandro Wasum; Medeiros, Israel Lopes de; Pêgo-Fernandes, Paulo Manuel; Fernandes, Flávio Guimarães; Unterpertinger, Fernando do Valle; Fernandes, Lucas Matos; Canzian, Mauro; Jatene, Fábio Biscegli

doi:10.1590/s1806-37132011000600013

Cited by 3 publications

(3 citation statements)

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“…In Brazil, clinical and experimental studies utilized the EVLP technique with the objective of both evaluation and pulmonary reconditioning. ( 4 , 16 – 18 )…”

Section: Introductionmentioning

confidence: 99%

Evaluation and reconditioning of donor organs for transplantation through ex vivo lung perfusion

Abdalla¹,

Oliveira-Braga²,

Fernandes³

et al. 2019

Einstein (São Paulo)

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Objective: To assess the feasibility and impact of ex vivo lung perfusion with hyperoncotic solution (Steen Solution ™ ) in the utilization of these organs in Brazil. Methods: In this prospective study, we subjected five lungs considered to be high risk for transplantation to 4 hours of ex vivo lung perfusion, with evaluation of oxygenation capacity. High-risk donor lungs were defined by specific criteria, including inflammatory infiltrates, pulmonary edema and partial pressure of arterial oxygen less than 300mmHg (inspired oxygen fraction of 100%). Results: During reperfusion, the mean partial pressure of arterial oxygen (inspired oxygen fraction of 100%) of the lungs did not change significantly (p=0.315). In the first hour, the mean partial pressure of arterial oxygen was 302.7mmHg (±127.66mmHg); in the second hour, 214.2mmHg (±94.12mmHg); in the third hour, 214.4mmHg (±99.70mmHg); and in the fourth hour, 217.7mmHg (±73.93mmHg). Plasma levels of lactate and glucose remained stable during perfusion, with no statistical difference between the moments studied (p=0.216). Conclusion: Ex vivo lung perfusion was reproduced in our center and ensured the preservation of lungs during the study period, which was 4 hours. The technique did not provide enough improvement for indicating organs for transplantation; therefore, it did not impact on use of these organs.

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“…In Brazil, clinical and experimental studies utilized the EVLP technique with the objective of both evaluation and pulmonary reconditioning. ( 4 , 16 – 18 )…”

Section: Introductionmentioning

confidence: 99%

Evaluation and reconditioning of donor organs for transplantation through ex vivo lung perfusion

Abdalla¹,

Oliveira-Braga²,

Fernandes³

et al. 2019

Einstein (São Paulo)

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“…14 The oxygenation capacity during the ex vivo perfusion can be considered to be the most important parameter for functional assessment, since it reflects both gas exchange and graft performance. Previous studies have shown that PaO 2 values correspond more reliably to the quality of lung preservation than do other parameters such as those from pathology or radiology.…”

Section: Discussionmentioning

confidence: 99%

Cold ischemia or topical-ECMO for lung preservation: a randomized experimental study

et al. 2014

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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. RESUMO CONTEXTO E OBJETIVO:A preservação pulmonar permanece um desafio para os grupos transplantadores. Com o desenvolvimento da perfusão pulmonar ex vivo, foi proposto um novo método de preservação chamado de ECMO-tópico (oxigenação de membrana extracorpórea). O presente estudo compara ECMOtópico com isquemia fria (IF) para preservação pulmonar em um modelo experimental ex vivo. TIPO DE ESTUDO E LOCAL: Estudo experimental randomizado, conduzido em uma faculdade de medicina pública. MÉTODO: Quatorze pulmões humanos foram retirados de sete doadores de morte cerebral considerados não aptos a transplante. O bloco pulmonar foi dividido e cada um foi aleatorizado para preservação por ECMO-tópico ou IF (4-7 °C) durante oito horas. Esses pulmões foram então re-conectados a um sistema de perfusão ex vivo para avaliação funcional. Biópsias pulmonares foram obtidas em três tempos. As variáveis funcionais avaliadas foram: capacidade de oxigenação (CO) e pressão de artéria pulmonar (PAP). As variáveis histológicas estudadas foram escore de lesão pulmonar (ELP) e contagem de células apoptóticas (CCA). RESULTADOS: A média da CO foi de 468 mmHg (± 81.6) no grupo ECMO-tópico e 455.8 (± 54) no grupo IF (P = 0,758); a PAP média foi de 140 mmHg (120-160) para ECMO-tópico e 140 mmHg (140-150) para IF (P = 0,285); o ELP médio foi 35,57 (± 4,5) no ECMO-tópico e 33,86 (± 6,1) no IF (P = 0,367). A CCA foi 25,00 (± 9,34) no grupo ECMO-tópico e 24,86 (± 10,374) no IF (P = 0...

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“…In 2007 we began preparations for EVLP via training courses and experimental studies with lungs rejected for transplantation. We initially sought to establish our methodology 15 , 16 , then tested lung preservation solutions 17 and static or continuous topical preservation methodologies 18 . This prepared us to perform the first lung transplantation using EVLP in Brazil in 2012.…”

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confidence: 99%