Lung preservation: pulmonary flush route affects bronchial mucosal temperature and expression of IFN-gamma and Gro in regional lymph nodes.
Optimal lung preservation via flush of the pulmonary vasculature minimizes early graft failure post-lung transplantation. We hypothesized that the route of pulmonary flush has differential effects on thermal gradients in the lung and expression of inflammatory mediators. Swine underwent antegrade flush (AG) via pulmonary artery; AG/RG: antegrade + retrograde flush via pulmonary veins or AG/BA: antegrade + bronchial artery flush via bronchial artery. Temperatures were recorded in bronchial mucosa and peribronchial lymph nodes. RT-PCR was utilized to detect cytokine gene expression in the nodes. AG/BA flush resulted in greatest cooling of bronchial mucosa and lymph nodes (p < 0.001). The route of flush did not affect expression of RANTES, MCP-1, IL-8, IL-1beta, TNF-alpha or IL-6. However, expression of Gro was reduced 4-h post-preservation in all groups. Only AG/BA resulted in decreased IFN-gamma transcripts. These data show that, compared to AG or AG/RG, AG/BA flush results in the greatest cooling of lung compartments and down regulates lymph node expression of a cytokine and chemokine that have key roles in inflammation and immunity. These data suggest that pulmonary flush via AG/BA during donor harvest may be optimal to decrease the risk of early graft failure.
Roe
David W
DW
Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
Fehrenbacher
John W
JW
Niemeier
Michael R
MR
Zieger
Michael
M
Labarrere
Carlos
C
Wilkes
David S
DS
D000818:Animals; D001831:Body Temperature; D001980:Bronchi / Q000473:pathology; D018932:Chemokine CCL2 / Q000096:biosynthesis; D018946:Chemokine CCL5 / Q000096:biosynthesis; D017931:DNA Primers / Q000737:chemistry; D005260:Female; D005786:Gene Expression Regulation; D006085:Graft Survival; D007371:Interferon-gamma / Q000096:biosynthesis / Q000378:metabolism; D007375:Interleukin-1 / Q000096:biosynthesis; D015850:Interleukin-6 / Q000096:biosynthesis; D016209:Interleukin-8 / Q000096:biosynthesis; D008168:Lung / Q000378:metabolism / Q000473:pathology*; D016040:Lung Transplantation / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D009092:Mucous Membrane / Q000378:metabolism / Q000473:pathology*; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions; D011309:Preservation, Biological / Q000379:methods*; D011651:Pulmonary Artery / Q000473:pathology; D011897:Random Allocation; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013552:Swine; D013696:Temperature; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis
D018932:Chemokine CCL2; D018946:Chemokine CCL5; D017931:DNA Primers; D007375:Interleukin-1; D015850:Interleukin-6; D016209:Interleukin-8; D019188:Organ Preservation Solutions; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma