2006 - UZ Leuven

Table 1Reperfusion time(min)PVR(dynesxsecxcm-5)PlatAwP(cmH2O)HBDCONTNHBDHBDCONTNHBD45 602600 ± 364*†1705 ± 1091291 ± 9616 ± 1*12 ± 114 ± 12634 ±371*†1894 ± 1371268 ± 11117 ± 1*12 ± 114 ± 1Table 2IL-8(pg.ml)IL-1β(pg/ml)HBDCONTNHBDHBDCONTNHBDRight (beforereperfusion)1138 ± 517*†272 ± 13325 ± 14196 ± 38*106 ± 12110 ± 12Left (afterreperfusion)2200 ± 533*†745 ± 337500 ± 111135 ± 2490 ± 995 ± 13Conclusion:1-h warm ischemic lungs are less susceptible to graftinjury than lungs retrieved 5 h after BD. This study further supports theclinical use of lungs from NHBD.NEYRINCK A.P., VAN DE WAUWER C., GEUDENS N., REGA F.R.,VERLEDEN G.M., WOUTERS P., LERUT T.E., VAN RAEMDONCK D.E.M.:Comparative study of donor lung injuriy in heart-beating versus nonheartbeating donors. Eur. J. Cardiothorac. Surg., 2006; 30: 628-636.Objective: The use of non-heart-beating donors (NHBD) has beenadvocated as an alternative to overcome the critical organ shortage inlung transplantation despite the warm ischemic period that may resultin primary graft dysfunction. On the contrary, brain death in the heartbeatingdonor (HBD) may be an underestimated risk factor for donorlung injury. We postulated that 60 min of warm ischemia in the NHBDis less detrimental to the lung than the pathophysiological changesafter brain death in the HBD. In this study we compared the quality oflungs from HBD versus NHBD in an isolated reperfusion model.Methods: Pigs (n=10 per group) were divided into three groups. Ingroup I (HBD), brain death was induced by acute inflation of anintracranial epidural balloon catheter. In group II (CONTROL), theballoon was not inflated. In group III (NHBD), cardiac arrest wasinduced by myocardial fibrillation. After 5 h of in situ mechanical109