title: Therapeutic effect of surfactant inhalation during warm ischemia in an isolated rat lung perfusion model.
abstract: Warm ischemia-reperfusion injury related to donation after cardiac death donors is a crucial and inevitable issue. As surfactant function is known to deteriorate during warm ischemia, we hypothesized that surfactant inhalation during warm ischemia would mitigate warm ischemia-reperfusion injury. We used an isolated rat lung perfusion model. The rats were divided into three groups: sham, control, and surfactant. In the control and surfactant groups, cardiac arrest was induced by ventricular fibrillation. Ventilation was restarted 110 min later; subsequently, the lungs were flushed, and heart and lung block was recovered. In the surfactant group, a natural bovine surfactant Surfacten(®) was inhaled for 3 min at the end of warm ischemia. Then, the lungs were reperfused for 80 min. Surfactant inhalation significantly improved graft functions, effectively increased lung tissue ATP levels, and significantly decreased mRNA levels of IL-6 and IL-6/IL-10 ratio at the end of reperfusion. Histologically, lungs in the surfactant group showed fewer signs of interstitial edema and hemorrhage, and significantly less neutrophilic infiltration than those in the control group. Our results indicated that surfactant inhalation in the last phase of warm ischemia maintained lung tissue energy levels and prevented cytokine production, resulting in the alleviation of warm ischemia-reperfusion injury.
authors: Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors: Akihiro
authors: A
authors: Ohsumi
authors: Fengshi
authors: F
authors: Chen
authors: Daisuke
authors: D
authors: Nakajima
authors: Jin
authors: J
authors: Sakamoto
authors: Tetsu
authors: T
authors: Yamada
authors: Takuji
authors: T
authors: Fujinaga
authors: Tsuyoshi
authors: T
authors: Shoji
authors: Hiroaki
authors: H
authors: Sakai
authors: Toru
authors: T
authors: Bando
authors: Hiroshi
authors: H
authors: Date
mesh_terms: D000255:Adenosine Triphosphate / Q000737:chemistry; D000280:Administration, Inhalation; D000336:Aerosols / Q000737:chemistry; D000818:Animals; D001835:Body Weight; D003643:Death; D006801:Humans; D016753:Interleukin-10 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D008168:Lung / Q000378:metabolism / Q000473:pathology*; D016040:Lung Transplantation / Q000379:methods; D008297:Male; D010477:Perfusion; D011312:Pressure; D051381:Rats; D011917:Rats, Inbred Lew; D015427:Reperfusion Injury / Q000628:therapy; D013501:Surface-Active Agents / Q000008:administration & dosage* / Q000737:chemistry; D009927:Tissue and Organ Procurement; D014048:Tolonium Chloride / Q000494:pharmacology; D052096:Warm Ischemia / Q000379:methods*
chemical_list: D000336:Aerosols; D015850:Interleukin-6; D013501:Surface-Active Agents; D016753:Interleukin-10; D014048:Tolonium Chloride; D000255:Adenosine Triphosphate