Effect of donor pre-mortem XXXX and @entity551 on graft function and start of warm @entity63 in donation after @entity204 lung transplantation.

@entity1707 @entity63 @entity35830 @entity519 @entity358 @entity3316 @entity1167 @entity551 @entity204
BACKGROUND: The start of warm ischemic time (WIT) of donor lungs in donation after @entity204 (DCD) is not clearly defined. We investigated the effect of donor pre-mortem @entity551 and @entity519 to determine which physiologic factor is the determinant of WIT onset in controlled DCD lung transplantation. METHODS: Twenty mechanically-ventilated donor @entity1707 were placed in 4 groups (n = 5 each) and exposed to each of the pseudo-agonal conditions for 60 minutes: (1) control group, no intervention and optimum ventilation, followed by @entity1167 ; (2) @entity551 ( @entity551 ) group, controlled @entity551 to <50 mm Hg, followed by @entity1167 ; (3) @entity3316 ( @entity3316 ) group, ventilation with room air at 5 breaths/min, followed by @entity1167 ; (4) non-circulation (NC) group, initial @entity1167 , followed by a 60-minute standoff time. The lung graft was retrieved and the left lung was transplanted to the recipient. Graft function was evaluated for 4 hours after @entity358 . The reperfusion injury was evaluated based on tissue cytokine expression, wet weight-to-dry weight ratio, and histology at the end of the reperfusion period. RESULTS: Impaired post-transplant graft function was seen in the @entity3316 group, which had significantly poorer oxygenation during the reperfusion period than the other groups (p < 0.001). The @entity3316 group also had higher tissue levels of @entity35830 (p < 0.05), a higher wet weight-to-dry weight ratio (p < 0.05), and histologic findings of graft tissue injury than the control group. The difference in these parameters among the control, @entity551 , and NC groups was not significant. CONCLUSIONS: Only pre-mortem @entity519 provoked by @entity3316 significantly impaired lung graft function in DCD lung transplantation. Ventilatory rather than circulatory deterioration can trigger the onset of warm @entity63 .
