Lung transplant reperfusion injury involves pulmonary macrophages and circulating leukocytes in a biphasic response.
OBJECTIVE
Both donor pulmonary macrophages and recipient circulating leukocytes may be involved in reperfusion injury after lung transplantation. By using the macrophage inhibitor gadolinium chloride and leukocyte filters, we attempted to identify the roles of these two populations of cells in lung transplant reperfusion injury.


METHODS
With our isolated, ventilated, blood-perfused rabbit lung model, all groups underwent lung harvest followed by 18-hour cold storage and 2-hour blood reperfusion. Measurements of pulmonary artery pressure, lung compliance, and arterial oxygenation were obtained. Group I (n = 8) served as a control. Group II (n = 8) received gadolinium chloride at 14 mg/kg 24 hours before lung harvest. Group III (n = 8) received leukocyte-depleted blood reperfusion by means of a leukocyte filter.


RESULTS
The gadolinium chloride group had significantly improved arterial oxygenation and pulmonary artery pressure measurements compared with control subjects and an improved arterial oxygenation compared with the filter group after 30 minutes of reperfusion. After 120 minutes of reperfusion, however, the filter group had significantly improved arterial oxygenation and pulmonary artery pressure measurements compared with the control group and an improved arterial oxygenation compared with the gadolinium chloride group.


CONCLUSIONS
Lung transplant reperfusion injury occurs in two phases. The early phase is mediated by donor pulmonary macrophages and is followed by a late injury induced by recipient circulating leukocytes.
Fiser
S M
SM
Department of Thoracic and Cardiovascular Surgery, University of Virginia Health Sciences Center, Charlottesville, VA 22908, USA. smf9e@virginia.edu
Tribble
C G
CG
Long
S M
SM
Kaza
A K
AK
Cope
J T
JT
Laubach
V E
VE
Kern
J A
JA
Kron
I L
IL
D000704:Analysis of Variance; D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D005682:Gadolinium / Q000494:pharmacology; D006085:Graft Survival; D007958:Leukocyte Count; D007962:Leukocytes / Q000187:drug effects / Q000502:physiology*; D008168:Lung / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology; D008170:Lung Compliance; D016040:Lung Transplantation / Q000009:adverse effects* / Q000379:methods / Q000502:physiology*; D008264:Macrophages / Q000187:drug effects / Q000502:physiology*; D008297:Male; D008851:Micropore Filters; D009929:Organ Size; D010100:Oxygen / Q000097:blood; D011817:Rabbits; D012016:Reference Values; D015427:Reperfusion Injury / Q000209:etiology* / Q000503:physiopathology*; D012680:Sensitivity and Specificity; D020858:Tissue and Organ Harvesting / Q000379:methods; D014655:Vascular Resistance
D005682:Gadolinium; C038958:gadolinium chloride; D010100:Oxygen