Lung Lavage and Surfactant Replacement During Ex Vivo Lung Perfusion for Treatment of Gastric Acid Aspiration–Induced Donor Lung Injury

摘要: Background Ex vivo lung perfusion (EVLP) provides opportunities to treat injured donor lungs before transplantation. We investigated whether lavage, eliminate inflammatory inhibitory components, followed by exogenous surfactant replacement, could aid recovery and improve post-transplant function after gastric aspiration injury. Methods Gastric acid was induced in pigs, which were ventilated for 6 hours develop After retrieval 10 of cold preservation, EVLP performed hours. The randomly divided into 4 groups (n = 5, each): (1) no treatment (control), (2) (3) administration, (4) administration. another 2-hour period the left transplanted reperfused Results Physiologic significantly improved administration during EVLP. perfusate from lavage + group showed lower levels interleukin (IL)-1β, IL-6, IL-8, secretory phospholipase A 2 . Total phosphatidylcholine increased, minimum surface tension recovered normal (≤5 mN/m) bronchioalveolar fluid Lysophosphatidylcholine than group. Post-transplant better compared with all other groups. Conclusions Lung replacement EVLP, reduced mediators prevented hydrolysis phosphatidylcholine, contributed superior