title: Platelet activation in the postoperative period after lung transplantation.
abstract: OBJECTIVE
  During lung transplantation, cells in the pulmonary parenchyma are subjected to ischemia, hypothermic storage, and reperfusion injury. Platelets, whose granular contents include adhesion receptors, chemokines, and coactivating substances that activate inflammatory and coagulant cascades, likely play a critical role in the lung allograft response to ischemia and reperfusion. The platelet response to the pulmonary allograft, however, has never been studied. Here we report significant platelet activation immediately after lung transplantation.
  
  
  METHODS
  We performed a prospective cohort study comparing markers of platelet activation in patients undergoing lung transplantation and patients undergoing nontransplant thoracotomy. Plasma levels of soluble P-selectin, soluble CD40 ligand, and platelet-leukocyte conjugates were measured before surgery, after skin closure, and at 6 postoperative hours.
  
  
  RESULTS
  Both soluble P-selectin and soluble CD40 ligand levels increased significantly after lung transplantation but not after thoracotomy. Additionally, platelet-monocyte conjugate fluorescence was significantly higher after lung transplantation than after thoracotomy alone.
  
  
  CONCLUSIONS
  These findings suggest that platelet activation is significantly increased after lung transplantation beyond that expected from the postoperative state. The increase in circulating platelet-monocyte conjugates suggests an important interaction between platelets and inflammatory cells. Further research should examine whether platelet activation affects early graft function after lung transplantation.
authors.affiliation: Lung Transplant Program, Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
authors.forename: David I
authors.initials: DI
authors.lastname: Sternberg
authors.forename: Daichi
authors.initials: D
authors.lastname: Shimbo
authors.forename: Steven M
authors.initials: SM
authors.lastname: Kawut
authors.forename: Joydeep
authors.initials: J
authors.lastname: Sarkar
authors.forename: Georg
authors.initials: G
authors.lastname: Hurlitz
authors.forename: Frank
authors.initials: F
authors.lastname: D'Ovidio
authors.forename: David J
authors.initials: DJ
authors.lastname: Lederer
authors.forename: Jessie S
authors.initials: JS
authors.lastname: Wilt
authors.forename: Selim M
authors.initials: SM
authors.lastname: Arcasoy
authors.forename: David J
authors.initials: DJ
authors.lastname: Pinsky
authors.forename: Jeanine M
authors.initials: JM
authors.lastname: D'Armiento
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Sonett
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D023201:CD40 Ligand / Q000378:metabolism*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D016027:Heart Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019007:P-Selectin / Q000378:metabolism*; D015539:Platelet Activation / Q000502:physiology*; D011184:Postoperative Period; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D012016:Reference Values; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D013908:Thoracotomy / Q000009:adverse effects / Q000379:methods
chemical_list: D015415:Biomarkers; D019007:P-Selectin; D023201:CD40 Ligand