C1-esterase inhibitor reduces reperfusion injury after lung transplantation

Scherer, Mirela; Demertzis, Stefanos; Langer, Frank; Moritz, Anton; Schäfers, Hans-Joachim (2002). C1-esterase inhibitor reduces reperfusion injury after lung transplantation. Annals of thoracic surgery, 1(73), 233-8; discussion 238-9. New York, N.Y.: Elsevier 10.1016/S0003-4975(01)03235-0

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BACKGROUND: Activation of the complement system and polymorphonuclear neutrophilic leukocytes plays a major role in mediating reperfusion injury after lung transplantation. We hypothesized that early interference with complement activation would reduce lung reperfusion injury after transplantation. METHODS: Unilateral left lung autotransplantation was performed in 6 sheep. After hilar stripping the left lung was flushed with Euro-Collins solution and preserved for 2 hours in situ at 15 degrees C. After reperfusion the right main bronchus and pulmonary artery were occluded, leaving the animal dependent on the reperfused lung (reperfused group). C1-esterase inhibitor group animals (n = 6) received 200 U/kg body weight of C1-esterase inhibitor as a short infusion, half 10 minutes before, the other half 10 minutes after reperfusion. Controls (n = 6) underwent hilar preparation only. Pulmonary function was assessed by alveolar-arterial oxygen difference and pulmonary vascular resistance. The release of beta-N-acetylglucosaminidase served as indicator of polymorphonuclear neutrophilic leukocyte activation. Extravascular lung water was an indicator for pulmonary edema formation. Biopsy specimens were taken from all groups 3 hours after reperfusion for light and electron microscopy. RESULTS: In the reperfused group, alveolar-arterial oxygen difference and pulmonary vascular resistance were significantly elevated after reperfusion. All animals developed frank alveolar edema. The biochemical marker beta-N-acetylglucosaminidase showed significant leukocyte activation. In the C1-esterase inhibitor group, alveolar-arterial oxygen difference, pulmonary vascular resistance, and the level of polymorphonuclear neutrophilic leukocyte activation were significantly lower. CONCLUSIONS: Treatment with C1-esterase inhibitor reduces reperfusion injury and improves pulmonary function in this experimental model.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Faculty Institutions > Teaching Staff, Faculty of Medicine
UniBE Contributor:	Demertzis, Stefanos
ISSN:	0003-4975
ISBN:	11834015
Publisher:	Elsevier
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 15:08
Last Modified:	05 Dec 2022 14:20
Publisher DOI:	10.1016/S0003-4975(01)03235-0
PubMed ID:	11834015
Web of Science ID:	000173334200052
URI:	https://boris.unibe.ch/id/eprint/29668 (FactScience: 157799)