title: Autologous endothelial progenitor cells improve allograft survival in porcine lung transplantation with prolonged ischemia.
abstract: BACKGROUND
  As endothelial progenitor cells (EPCs) attenuated acute lung injury (ALI) in rabbit model, we hypothesized that autologous EPCs preserved lung graft function during the acute reperfusion period of lung transplantation and tested the therapeutic potential of EPCs in a porcine model of lung transplantation with prolonged graft ischemia.
  
  
  METHODS
  Day-7 EPCs isolated from the recipient subjects or plain culture media were administered into the left pulmonary artery immediately before restoration of pulmonary blood flow in a porcine lung allotransplantation model, with the transplantation surgeons blinded to the content of injection. Hemodynamics and arterial blood gas were recorded, and the right pulmonary artery was occluded 30 min after reperfusion to evaluate the lung graft function. The lung grafts were sectioned for histological examination at the end of experiments. The total ischemic time for lung graft was approximately 14 h.
  
  
  RESULTS
  All animals receiving plain medium died within 40 min after reperfusion, but 3 out of 5 (60%) piglets receiving EPCs survived up to 4 h after diversion of the entire cardiac output into the lung graft (P<0.01). The donor body weight, recipient body weight, cold ischemic time, and time for anastomosis were comparable between the EPC and control group (P=0.989, 0.822, 0.843, and 0.452, respectively). The mean aortic pressure decreased, and the cardiac output and mean pulmonary artery pressure elevated after right pulmonary artery occlusion. All these parameters were gradually compensated in the EPC group but decompensated in the control group. Better preservation of gas exchange function, reduced thrombi formation in the terminal pulmonary arterioles, and attenuated interstitial hemorrhage of the lung graft were observed in the EPC group.
  
  
  CONCLUSIONS
  We concluded autologous EPCs significantly enhanced the function of lung allograft and improved survival in a porcine model of lung transplantation with prolonged ischemia.
authors: Division of Thoracic Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medical College, National Cheng Kung University, Tainan, Taiwan;; Institube of Clinical Medicine, College of Medical College, National Cheng Kung University, Tainan, Taiwan;
authors: Yi-Ting
authors: YT
authors: Yen
authors: Institube of Clinical Medicine, College of Medical College, National Cheng Kung University, Tainan, Taiwan;; Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medical College, National Cheng Kung University, Tainan, Taiwan;
authors: Jun-Neng
authors: JN
authors: Roan
authors: Department of Anesthesiology, National Cheng Kung University Hospital, College of Medical College, National Cheng Kung University, Tainan, Taiwan ;
authors: Shih-Yuan
authors: SY
authors: Fang
authors: Department of Anesthesiology, National Cheng Kung University Hospital, College of Medical College, National Cheng Kung University, Tainan, Taiwan ;
authors: Shi-Wei
authors: SW
authors: Chang
authors: Division of Thoracic Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medical College, National Cheng Kung University, Tainan, Taiwan ;
authors: Yau-Lin
authors: YL
authors: Tseng
authors: Department of Anesthesiology, National Cheng Kung University Hospital, College of Medical College, National Cheng Kung University, Tainan, Taiwan;; Department of Anesthesiology, Buddhist Tzu Chi General Hospital and Tzu Chi University School of Medicine, Hualien, Taiwan.
authors: Chen-Fuh
authors: CF
authors: Lam
keywords: Endothelial progenitor cells (EPCs); allograft survival; lung transplantation; porcine