1. Xenogeneic cross-circulation for extracorporeal recovery of injured human lungs.
- Author
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Hozain AE, O'Neill JD, Pinezich MR, Tipograf Y, Donocoff R, Cunningham KM, Tumen A, Fung K, Ukita R, Simpson MT, Reimer JA, Ruiz EC, Queen D, Stokes JW, Cardwell NL, Talackine J, Kim J, Snoeck HW, Chen YW, Romanov A, Marboe CC, Griesemer AD, Guenthart BA, Bacchetta M, and Vunjak-Novakovic G
- Subjects
- Acute Lung Injury blood, Acute Lung Injury physiopathology, Animals, Extracorporeal Circulation methods, Humans, Lung physiopathology, Perfusion methods, Swine, Tissue Donors, Acute Lung Injury therapy, Lung blood supply, Lung Transplantation methods, Organ Preservation methods
- Abstract
Patients awaiting lung transplantation face high wait-list mortality, as injury precludes the use of most donor lungs. Although ex vivo lung perfusion (EVLP) is able to recover marginal quality donor lungs, extension of normothermic support beyond 6 h has been challenging. Here we demonstrate that acutely injured human lungs declined for transplantation, including a lung that failed to recover on EVLP, can be recovered by cross-circulation of whole blood between explanted human lungs and a Yorkshire swine. This xenogeneic platform provided explanted human lungs a supportive, physiologic milieu and systemic regulation that resulted in functional and histological recovery after 24 h of normothermic support. Our findings suggest that cross-circulation can serve as a complementary approach to clinical EVLP to recover injured donor lungs that could not otherwise be utilized for transplantation, as well as a translational research platform for immunomodulation and advanced organ bioengineering.
- Published
- 2020
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