Lung Transplant Recipients with Severe Primary Graft Dysfunction Requiring ECMO Had Similar Donor-Derived Cell-Free DNA Levels and Lung Function as Matched Controls

2020 ◽  
Vol 39 (4) ◽  
pp. S329-S330
Author(s):  
I. Timofte ◽  
A. Iacono ◽  
M. Terrin ◽  
R. Vesselinov ◽  
K. Bhatti ◽  
...  
Keyword(s):  
Lung Function ◽  
Lung Transplant ◽  
Transplant Recipients ◽  
Primary Graft Dysfunction ◽  
Graft Dysfunction ◽  
Cell Free Dna ◽  
Free Dna ◽  
Lung Transplant Recipients

scholarly journals HIGHER DONOR PAO2/FIO2 RATIO APPEARS TO BE ASSOCIATED WITH INCREASED INCIDENCE OF PRIMARY GRAFT DYSFUNCTION IN LUNG TRANSPLANT RECIPIENTS

CHEST Journal ◽  
2020 ◽  
Vol 158 (4) ◽  
pp. A2399-A2400
Author(s):  
Vikramjit Khangoora ◽  
Christopher King ◽  
Oksana Shlobin ◽  
Anne Brown ◽  
Shambhu Aryal ◽  
...  
Keyword(s):  
Lung Transplant ◽  
Transplant Recipients ◽  
Primary Graft Dysfunction ◽  
Graft Dysfunction ◽  
Lung Transplant Recipients

scholarly journals Early protein expression profile in bronchoalveolar lavage fluid and clinical outcomes in primary graft dysfunction after lung transplantation

2020 ◽  
Vol 58 (2) ◽  
pp. 379-388
Author(s):  
Anna E Frick ◽  
Stijn E Verleden ◽  
Sofie Ordies ◽  
Annelore Sacreas ◽  
Robin Vos ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Lung Transplantation ◽  
Lung Transplant ◽  
Bronchoalveolar Lavage Fluid ◽  
Lavage Fluid ◽  
Enzyme Linked Immunosorbent Assay ◽  
Transplant Recipients ◽  
Primary Graft Dysfunction ◽  
Graft Dysfunction ◽  
Lung Transplant Recipients

Abstract OBJECTIVES Primary graft dysfunction (PGD) remains a major post-transplant complication and is associated with increased morbidity and mortality. Mechanisms evoking PGD are not completely clear, but inflammation plays a central role. We investigated the association between PGD and inflammatory proteins present in immediate postoperative bronchoalveolar lavage. METHODS All double-lung recipients transplanted at our institution from 2002 to 2018 were included in our study. We retrospectively selected 80 consecutive lung transplant recipients with different PGD grades (n = 20 for each PGD grades 0–1 to 2–3). In bronchoalveolar lavage performed within the first 24 h after donor aortic cross-clamping following lung transplantation, concentrations of 30 cytokines, chemokines and growth factors were assessed by enzyme-linked immunosorbent assay (ELISA) and correlated with donor and recipient demographics and outcomes. For analysis, 2 groups were defined: ‘mild’ PGD (grade 0–1) and ‘severe’ PGD (grades 2–3). RESULTS Significant differences between mild and severe PGD were found in 8 biomarkers [interleukin (IL)-6, IL-10, IL-13, eotaxin, granulocyte colony-stimulating factor, interferon γ, macrophage inflammatory protein 1α, surfactant protein D (SP-D); P < 0.05]. Increased IL-10 and IL-13, but none of the other proteins, were associated with short-term outcome (longer time to extubation; P = 0.005 and P < 0.0001; increased intensive care unit stay; P = 0.012 and P < 0.0001; and hospital stay; P = 0.041 and P = 0.002). There were no significant differences in donor and recipient characteristics between the groups. CONCLUSIONS Expression profiles of key inflammatory mediators in bronchoalveolar lavage fluid differed significantly between lung transplant recipients with severe versus mild PGD and correlated with clinical outcome variables. Further research should focus on the early mechanisms leading to PGD.

scholarly journals Protein biomarkers associated with primary graft dysfunction following lung transplantation

2017 ◽  
Vol 312 (4) ◽  
pp. L531-L541 ◽  
Author(s):  
B. C. S. Hamilton ◽  
J. Kukreja ◽  
L. B. Ware ◽  
M. A. Matthay
Keyword(s):  
Lung Transplant ◽  
Bronchoalveolar Lavage Fluid ◽  
Lavage Fluid ◽  
Transplant Recipients ◽  
Primary Graft Dysfunction ◽  
Graft Dysfunction ◽  
Protein Biomarkers ◽  
Epithelial Injury ◽  
Lung Transplant Recipients ◽  
Biologic Factors

Severe primary graft dysfunction affects 15–20% of lung transplant recipients and carries a high mortality risk. In addition to known donor, recipient, and perioperative clinical risk factors, numerous biologic factors are thought to contribute to primary graft dysfunction. Our current understanding of the pathogenesis of lung injury and primary graft dysfunction emphasizes multiple pathways leading to lung endothelial and epithelial injury. Protein biomarkers specific to these pathways can be measured in the plasma, bronchoalveolar lavage fluid, and lung tissue. Clarification of the pathophysiology and timing of primary graft dysfunction could illuminate predictors of dysfunction, allowing for better risk stratification, earlier identification of susceptible recipients, and development of targeted therapies. Here, we review much of what has been learned about the association of protein biomarkers with primary graft dysfunction and evaluate this association at different measurement time points.

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