Premium
Donor prone positioning protects lungs from injury during warm ischemia
Author(s) -
Watanabe Yui,
Galasso Marcos,
Watanabe Tatsuaki,
Ali Aadil,
Qaqish Robert,
Nakajima Daisuke,
Taniguchi Yohei,
Pipkin Mauricio,
Caldarone Lindsay,
Chen Manyin,
Kanou Takashi,
Summers Cara,
Ramadan Khaled,
Zhang Yu,
Chan Harley,
Waddell Thomas K.,
Liu Mingyao,
Keshavjee Shaf,
del Sorbo Lorenzo,
Cypel Marcelo
Publication year - 2019
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.15363
Subject(s) - medicine , asystole , lung , supine position , anesthesia , perfusion , ischemia , lung transplantation , ventilation (architecture) , cardiology , mechanical engineering , engineering
A large proportion of controlled donation after circulatory death ( cDCD ) donor lungs are declined because cardiac arrest does not occur within a suitable time after the withdrawal of life‐sustaining therapy. Improved strategies to preserve lungs after asystole may allow the recovery team to arrive after death actually occurs and enable the recovery of lungs from more cDCD donors. The aim of this study was to determine the effect of donor positioning on the quality of lung preservation after cardiac arrest in a cDCD model. Cardiac arrest was induced by withdrawal of ventilation under anesthesia in pigs. After asystole, animals were divided into 2 groups based on body positioning (supine or prone). All animals were subjected to 3 hours of warm ischemia. After the observation period, donor lungs were explanted and preserved at 4°C for 6 hours, followed by 6 hours of physiologic and biological lung assessment under normothermic ex vivo lung perfusion. Donor lungs from the prone group displayed significantly greater quality as reflected by better function during ex vivo lung perfusion, less edema formation, less cell death, and decreased inflammation compared with the supine group. A simple maneuver of donor prone positioning after cardiac arrest significantly improves lung graft preservation and function.