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Hormonal Treatment During Ex Vivo Lung Perfusion Ameliorates Brain Death Induced Inflammation
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DOI：10.1111/aor.70119.png)
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Abstract
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Background Lung transplantation remains the primary option to treat end-stage lung disease, and treatments aiming to improve graft quality are necessary. Ex vivo lung perfusion (EVLP) is a strategy that allows the organ to be assessed and reconditioned before transplantation. Treatment of the donor with a combination of 17 beta-estradiol (E2) and methylprednisolone (MP) has been shown to improve lung quality after brain death (BD). All considered, this study aimed to investigate E2 and MP association during EVLP.Methods Males and females Wistar rats underwent BD induction and were maintained for 4 h. Naive animals were used as control. After BD, the pulmonary artery was cannulated, the heart-lung en bloc was collected, submitted to cold ischemia (1 h) and then placed in an EVLP system (4 h). Perfusion solution was home-made perfusate added or not with the treatment (T: MP, 40 mg; E2: 5 mu g/mL). Groups were defined as male and female rats, divided as follows: BD (without perfusion), EVLP (without treatment), EVLP+Treat (with treatment).Results Male EVLP+Treat presented increased dynamic and static compliance, increased paO2, and reduced elastance. Treated males also presented reduced iNOS and MPO and increased perfusion flow. Both female perfused groups presented reduced MPO and adhesion molecules. Female EVLP+Treat also presented increased flow. No difference in lung function was observed in females.Conclusion Our results point to a positive effect in the combined use of E2 and MP during EVLP by improving lung function and decreasing inflammation, especially in males.
Keywords:
17 beta-estradiol
ex vivo perfusion
lung
methylprednisolone
sex differences
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