Preview

Transplantologiya. The Russian Journal of Transplantation

Advanced search

The effect of phosphodiesterase-5 inhibitors on the alveolar blood fl ow in the pulmonary graft

Abstract

Lung transplantation – an effective way to radical surgical treatment of chronic lung disease in the terminal stage. The use of drugs with extending effect on vascular smooth musculature of the pulmonary circulatory system, prior to conservation and assessment of the functional state of the microvasculature in the postreperfusion period may result in improved clinical outcomes of such operations and increase the duration of the functioning of the lung transplant in the body of the recipient.

Fifty four animals were used (German Field Pig, 32,3±0,6 kg, male). Forty two animals (donors and recipients) were divided into three groups according to the method of conservation. Orthogonally polarized spectral video microscopy (OPSVM) was applied for estimation the parameters of microcirculation.

Injection of a phosphodiesterase-5 (PDE-5) inhibitor into the pulmonary trunk at 20 min before conservation significantly increases the total length of open alveolar capillaries per field (486,3±258,1 mkm in comparison to the initial 240,8±127,9 mkm; p<0,001) and the index of capillary blood flow of the alveoli (515,0 in comparison to the initial 249,2 mkm/mkm2; p<0,001), also the increase of the mean diameter of the alveoli was found (91,2±52,3 mkm in comparison to the initial 85,1±41,5 mkm; p<0,05).

The use of PDE-5 inhibitor at 20 min before the start of perfusion of lung transplant with conservation solution improves the oxygenizing ability of the transplanted lung. OPSVM is a reliable method for assessing and monitoring the parameters of microcirculation of lung tissue in vivo.

 

About the Authors

P. K. Yablonskiy
FSBI «St. Petersburg Research Institute of Phthisiopulmonology» Ministry of Health of the Russian Federation, St. Petersburg
Russian Federation


O. N. Reznik
SEI «The First St. Petersburg State Medical University named after I.P. Pavlov» Ministry of Health of the Russian Federation, St. Petersburg
Russian Federation


A. E. Skvortsov
SEI «The First St. Petersburg State Medical University named after I.P. Pavlov» Ministry of Health of the Russian Federation, St. Petersburg
Russian Federation


V. E. Milehin
FSBI «St. Petersburg Research Institute of Phthisiopulmonology» Ministry of Health of the Russian Federation, St. Petersburg,
Russian Federation


References

1. Первая трансплантация легких в НИИ скорой помощи им. Н.В. Склифосовского / М.Ш. Хубутия [и др.] // Трансплантология. – 2011. – № 2–3. – С. 5–9.

2. The Registry of the International Society for Heart and Lung Transplantation: Twenty-eighth Adult Lung and Heart – Lung Transplant Report – 2011 / J.D. Christie [et al.] // J. Heart Lung. Transplant. – 2011. – Vol. 30, N 10. – P. 1104–1122.

3. Трансплантология: Руководство для врачей / Под ред. В.И. Шумакова. – М.: МИА, 2006.– 544 c.

4. Clinical risk factors for primary graft dysfunction after lung transplantation / J.M. Diamond [et al.] // Am. J. Respir. Crit. Care Med. – 2013. – Vol. 187, N 5. – P. 527–534.

5. Ahmad, S. Pulmonary complications of lung transplantation / S. Ahmad, O.A. Shlobin, S.D. Nathan // Chest. – 2011. – Vol. 139, N 2. – P. 402–411.

6. The impact of prolonged cold preservation on the graft function and gene expression levels in an experimental lung transplantation model / O. Yoshida [et al.] // Surg. Today. – 2013. – Vol. 43, N 1. – P. 81–87.

7. Cellular electrophysiologic and mechanical evidence of superior vascular protection in pul-monarymicrocirculation by Perfadex compared with Celsior / M. Wu [et al.] // J. Thorac. Cardiovascular. Surg. – 2009. – Vol. 137, N 2. – P. 492–498.

8. Normothermic perfusion of donor lungs for preservation and assessment with the Organ Care System Lung before bilateral transplantation: a pilot study of 12 patients / G. Warnecke [et al.] // Lancet. – 2012. – Vol. 380, N 9856. – P. 1851–1858.

9. Guidelines for the diagnosis and treatment of pulmonary hypertension / N. Galie [et al.] // Eur. Heart J. – 2009. – Vol. 30, N 20. – P. 2493–2537.

10. Sildenafil versus endothelin receptor antagonist for pulmonary hypertension (SERAPH) study / M.R. Wilkins [et al.] // Am. J. Resp. Crit. Care. – 2005. – Vol. 171, N 11. – P. 1292–1297.

11. Ex vivo rehabilitation of non-heartbeating donor lungs in preclinical porcine model: delayed perfusion results in superior lung function / D.P. Mulloy [et al.] // J. Thorac. Cardiovasc. Surg. – 2012. – Vol. 144, N 5. – P. 1208–1215.

12. Ex vivo lung reconditioning: a new era for lung transplantation / A.W. Mariani, P.M. P go-Fernandes, L.G. Abdalla, F.B. Jatene // J. Bras. Pneumol. – 2012. – Vol. 38, N 6. – P. 776–785.

13. Transplantation of initially rejected donor lungs after ex vivo lung perfusion / A. Wallinder [et al.] // J. Thorac. Cardiovasc. Surg. – 2012. – Vol. 144, N 5. – P. 1222–1228.

14. First human transplantation of a nonacceptable donor lung afterreconditioning ex vivo / S. Steen [et al.] // Ann. Thorac. Surg. – 2007. – Vol. 83, N 6. – P. 2191–2194.

15. Experience with the first 50 ex vivo lung perfusions in clinical transplantation / M.J. Cypel [et al.] // Thorac. Cardiovasc Surg. – 2012. – Vol. 144, N 5. – P. 1200– 1206.

16. Comparison of lung preservation solutions in human lungs using an ex vivo lung perfusion experimental model / I.L. Medeiros [et al.] // Clinics (Sao Paulo). – 2012. – Vol. 67, N 9. – P. 1101–1106.

17. A new porcine model of reperfusion injury after lung transplantation /S.C. Clark [et al.] // Lab. Anim. – 1999. – Vol. 33, N 2. – P. 135–142.

18. A new model for the assessment of lung allograft ischemia/reperfusion injury / S. Hillinger [et al.] // J. Invest. Surg. – 2000.– Vol. 13, N 1. – P. 59–65.

19. Pretreatment strategy with adenosine A2A receptor agonist attenuates reperfusion injury in a preclinical porcinelung transplantation model / D.J. LaPar [et al.] // J. Thorac. Cardiovasc. Surg. – 2011.– Vol. 142, N 4. – P. 887–894.

20. In vivo imaging of human pancreatic microcirculation and pancreatic tissue injury in clinical pancreas transplantation / K.D. Schaser [et al.] // Am. J. Transplant. – 2005. – Vol. 5, N 2. – P. 341–350.

21. In vivo visualization of early microcirculatory changes following ischemia/reperfusion injury in human kidney transplantation / V. Schmitz [et al.] // Eur Surg Res. – 2008. – Vol. 40, N 1. – P. 19–25.

22. An experimental approach toward chronic pulmonary allograft rejection: Orthotopic lung versus heterotopic tracheal segment transplantation in rats / W. Jungraithmayr [et al.] // Transplant. Proc. – 2010. – Vol. 42, N 7. – P. 2767–2770.

23. Wilkes, D.S. Chronic lung allograft rejection and airway microvasculature: is HIF-1 the missing link? / D.S. Wilkes // J. Clin. Invest. – 2011. – Vol. 121, N 6. – P. 2155–2157.


Review

For citations:


Yablonskiy P.K., Reznik O.N., Skvortsov A.E., Milehin V.E. The effect of phosphodiesterase-5 inhibitors on the alveolar blood fl ow in the pulmonary graft. Transplantologiya. The Russian Journal of Transplantation. 2013;(3):28-33. (In Russ.)

Views: 645


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2074-0506 (Print)
ISSN 2542-0909 (Online)