Ex Vivo Perfusion Treatment of Infection in Human Donor Lungs.
Ex vivo lung perfusion (EVLP) is a platform to treat infected donor lungs with antibiotic therapy before lung transplantation. Human donor lungs that were rejected for transplantation because of clinical concern regarding infection were randomly assigned to two groups. In the antibiotic group (n = 8), lungs underwent EVLP for 12 h with high-dose antibiotics (ciprofloxacin 400 mg or azithromycin 500 mg, vancomycin 15 mg/kg, and meropenem 2 g). In the control group (n = 7), lungs underwent EVLP for 12 h without antibiotics. A quantitative decrease in bacterial counts in bronchoalveolar lavage (BAL) was found in all antibiotic-treated cases but in only two control cases. Perfusate endotoxin levels at 12 h were significantly lower in the antibiotic group compared with the control group. EVLP with broad-spectrum antibiotic therapy significantly improved pulmonary oxygenation and compliance and reduced pulmonary vascular resistance. Perfusate endotoxin levels at 12 h were strongly correlated with levels of perfusates tumor necrosis factor α, IL-1β and macrophage inflammatory proteins 1α and 1β at 12 h. In conclusion, EVLP treatment of infected donor lungs with broad-spectrum antibiotics significantly reduced BAL bacterial counts and endotoxin levels and improved donor lung function.
['Nakajima|D|D|', 'Cypel|M|M|', 'Bonato|R|R|', 'Machuca|T N|TN|', 'Iskender|I|I|', 'Hashimoto|K|K|', 'Linacre|V|V|', 'Chen|M|M|', 'Coutinho|R|R|', 'Azad|S|S|', 'Martinu|T|T|', 'Waddell|T K|TK|', 'Hwang|D M|DM|', 'Husain|S|S|', 'Liu|M|M|', 'Keshavjee|S|S|']
D000328:Adult D000890:Anti-Infective Agents D058491:Bacterial Load D001992:Bronchoalveolar Lavage Fluid D001996:Bronchopneumonia D016022:Case-Control Studies D005112:Extracorporeal Circulation D005260:Female D005500:Follow-Up Studies D006801:Humans D008168:Lung D016040:Lung Transplantation D008297:Male D008875:Middle Aged D010477:Perfusion D011379:Prognosis D014019:Tissue Donors D009927:Tissue and Organ Procurement
bacterial basic (laboratory) research/science cytokines/cytokine receptors donors and donation: donor derived infections donors and donation: donor evaluation infection and infectious agents lung transplantation/pulmonology organ perfusion and preservation translational research/science