Evaluation of Tissue Ischemia/Reperfusion Injury in Lung Recipients Supported by Intraoperative Extracorporeal Membrane Oxygenation: A Single-Center Pilot Study
Intraoperative veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) as intraoperative hemodynamic support during lung transplantation is becoming a standard practice due to promising clinical results. Nevertheless, studies on tissue/molecular pathways investigating ischemia/reperfusion inju...
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MDPI AG
2022-11-01
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| Online Access: | https://www.mdpi.com/2073-4409/11/22/3681 |
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| author | Fiorella Calabrese Federica Pezzuto Francesco Fortarezza Francesca Lunardi Eleonora Faccioli Giulia Lorenzoni Annalisa Boscolo Nicolò Sella Dario Gregori Marco Schiavon Paolo Navalesi Andrea Dell’Amore Federico Rea |
| author_facet | Fiorella Calabrese Federica Pezzuto Francesco Fortarezza Francesca Lunardi Eleonora Faccioli Giulia Lorenzoni Annalisa Boscolo Nicolò Sella Dario Gregori Marco Schiavon Paolo Navalesi Andrea Dell’Amore Federico Rea |
| author_sort | Fiorella Calabrese |
| collection | DOAJ |
| description | Intraoperative veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) as intraoperative hemodynamic support during lung transplantation is becoming a standard practice due to promising clinical results. Nevertheless, studies on tissue/molecular pathways investigating ischemia/reperfusion injury are still lacking. Patients receiving a bilateral lung transplantation between January 2012 and December 2018 at the University Hospital of Padova were included in this retrospective single-center observational study. The present study aimed to investigate ischemia/reperfusion injury in 51 tissue specimens obtained from 13 recipients supported by intraoperative VA-ECMO and 38 who were not. Several tissue analyses, including apoptosis evaluation and inducible nitric oxide synthase expression, were performed on the biopsies at the time of transplantation. Lung samples from the ECMO group (both pre- and post-reperfusion) were comparable, or for some parameters better, than samples from the non-ECMO group. Leukocyte margination was significantly lower in the ECMO group than in the non-ECMO group. Primary graft dysfunction, mainly at 24 and 48 h, was correlated with the tissue injury score of the post-reperfusion biopsy. The interquartile ranges for all morphological parameters showed high grade variability between pre- and post-reperfusion in the non-ECMO group. These preliminary data support the use of intraoperative ECMO based on lower lung tissue ischemia/reperfusion injury. Larger case series are mandatory to confirm our findings. |
| first_indexed | 2024-03-09T18:24:29Z |
| format | Article |
| id | doaj.art-70e96b25e6354501bcf402b2de5b409c |
| institution | Directory Open Access Journal |
| issn | 2073-4409 |
| language | English |
| last_indexed | 2024-03-09T18:24:29Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cells |
| spelling | doaj.art-70e96b25e6354501bcf402b2de5b409c2023-11-24T07:59:18ZengMDPI AGCells2073-44092022-11-011122368110.3390/cells11223681Evaluation of Tissue Ischemia/Reperfusion Injury in Lung Recipients Supported by Intraoperative Extracorporeal Membrane Oxygenation: A Single-Center Pilot StudyFiorella Calabrese0Federica Pezzuto1Francesco Fortarezza2Francesca Lunardi3Eleonora Faccioli4Giulia Lorenzoni5Annalisa Boscolo6Nicolò Sella7Dario Gregori8Marco Schiavon9Paolo Navalesi10Andrea Dell’Amore11Federico Rea12Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, 35128 Padova, ItalyInstitute of Anesthesia and Intensive Care, Padova University Hospital, 35128 Padova, ItalyInstitute of Anesthesia and Intensive Care, Padova University Hospital, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, 35128 Padova, ItalyInstitute of Anesthesia and Intensive Care, Padova University Hospital, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, 35128 Padova, ItalyIntraoperative veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) as intraoperative hemodynamic support during lung transplantation is becoming a standard practice due to promising clinical results. Nevertheless, studies on tissue/molecular pathways investigating ischemia/reperfusion injury are still lacking. Patients receiving a bilateral lung transplantation between January 2012 and December 2018 at the University Hospital of Padova were included in this retrospective single-center observational study. The present study aimed to investigate ischemia/reperfusion injury in 51 tissue specimens obtained from 13 recipients supported by intraoperative VA-ECMO and 38 who were not. Several tissue analyses, including apoptosis evaluation and inducible nitric oxide synthase expression, were performed on the biopsies at the time of transplantation. Lung samples from the ECMO group (both pre- and post-reperfusion) were comparable, or for some parameters better, than samples from the non-ECMO group. Leukocyte margination was significantly lower in the ECMO group than in the non-ECMO group. Primary graft dysfunction, mainly at 24 and 48 h, was correlated with the tissue injury score of the post-reperfusion biopsy. The interquartile ranges for all morphological parameters showed high grade variability between pre- and post-reperfusion in the non-ECMO group. These preliminary data support the use of intraoperative ECMO based on lower lung tissue ischemia/reperfusion injury. Larger case series are mandatory to confirm our findings.https://www.mdpi.com/2073-4409/11/22/3681ischemia/reperfusion injuryprimary graft dysfunctionextracorporeal membrane oxygenation |
| spellingShingle | Fiorella Calabrese Federica Pezzuto Francesco Fortarezza Francesca Lunardi Eleonora Faccioli Giulia Lorenzoni Annalisa Boscolo Nicolò Sella Dario Gregori Marco Schiavon Paolo Navalesi Andrea Dell’Amore Federico Rea Evaluation of Tissue Ischemia/Reperfusion Injury in Lung Recipients Supported by Intraoperative Extracorporeal Membrane Oxygenation: A Single-Center Pilot Study Cells ischemia/reperfusion injury primary graft dysfunction extracorporeal membrane oxygenation |
| title | Evaluation of Tissue Ischemia/Reperfusion Injury in Lung Recipients Supported by Intraoperative Extracorporeal Membrane Oxygenation: A Single-Center Pilot Study |
| title_full | Evaluation of Tissue Ischemia/Reperfusion Injury in Lung Recipients Supported by Intraoperative Extracorporeal Membrane Oxygenation: A Single-Center Pilot Study |
| title_fullStr | Evaluation of Tissue Ischemia/Reperfusion Injury in Lung Recipients Supported by Intraoperative Extracorporeal Membrane Oxygenation: A Single-Center Pilot Study |
| title_full_unstemmed | Evaluation of Tissue Ischemia/Reperfusion Injury in Lung Recipients Supported by Intraoperative Extracorporeal Membrane Oxygenation: A Single-Center Pilot Study |
| title_short | Evaluation of Tissue Ischemia/Reperfusion Injury in Lung Recipients Supported by Intraoperative Extracorporeal Membrane Oxygenation: A Single-Center Pilot Study |
| title_sort | evaluation of tissue ischemia reperfusion injury in lung recipients supported by intraoperative extracorporeal membrane oxygenation a single center pilot study |
| topic | ischemia/reperfusion injury primary graft dysfunction extracorporeal membrane oxygenation |
| url | https://www.mdpi.com/2073-4409/11/22/3681 |
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