Temperature dynamics of donor lungs from procurement to reperfusion: Static ice versus controlled hypothermic storage

IF 6 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Heart and Lung Transplantation Pub Date : 2025-03-19 DOI:10.1016/j.healun.2025.02.1695

Ismail Cenik MD , Jan Van Slambrouck MD, PhD , Annalisa Barbarossa MD , Cedric Vanluyten MD , Xin Jin MD , Elena Prisciandaro MD , An-Lies Provoost MD , Christelle M. Vandervelde MD , René Novysedlák MD, PhD , Ömer Serçik MSc , Paul De Leyn MD, PhD , Hans Van Veer MD , Lieven Depypere MD, PhD , Yanina Jansen MD, PhD , Jacques Pirenne MD, PhD , Dirk E. Van Raemdonck MD, PhD , Laurens J. Ceulemans MD, PhD

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Abstract

Background

Ischemia-reperfusion injury (IRI) remains an important challenge in lung transplantation (LTx). Ischemia can be divided into 3 phases: cooling during procurement, preservation, and rewarming during implantation. Temperature fluctuations influence metabolic processes, exacerbating IRI. However, actual lung temperatures have not been previously studied. Therefore, we aimed to characterize lung temperature dynamics in clinical LTx for static ice storage (SIS) and controlled hypothermic storage (CHS).

Methods

From December 2022 to February 2024, we included 35 SIS and 19 CHS bilateral LTx cases at a single center, resulting in 70 SIS and 38 CHS lungs. Surface temperature (surfaceT°) was measured with a thermography camera. Preservation temperature (preservationT°) was remotely recorded for 6 SIS and 6 CHS. Core temperature (coreT°) was measured with a flexible probe in the lower lobe bronchus after unpacking and every 10 minutes during implantation.

Results

Regarding SIS, mean ± standard deviation (SD) surfaceT° was 30°C ± 3.3°C before flushing, 17°C ± 4.1 °C after extraction, 8.6°C ± 3.3°C before packing. PreservationT° reached 4°C after 98 minutes and 0°C after 266 minutes. After unpacking, surfaceT° was 1.8°C ± 2.3°C, coreT° was 1.6°C ± 1.2°C. At 30 minutes implantation, surfaceT° was 25.0°C ± 2.9°C, coreT° was 22.0°C ± 4.4°C. CHS surfaceT° was 30.0°C ± 2.5°C before flushing, 17°C ± 3.8°C after extraction, and 11°C ± 3.5°C before packing. After unpacking, surfaceT° was 7.9°C ± 2.0°C, and coreT° was 7.1°C ± 1.1°C. At 30 minutes of implantation, surfaceT° was 26.0°C ± 1.7°C, and coreT° was 24.0°C ± 3.6°C. Postoperative outcome was comparable between both groups.

Conclusions

We characterized temperature dynamics in clinical LTx, revealing a rapid temperature drop with pulmonary flushing, potential freezing injury with SIS, and rapid rewarming during implantation.

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供体肺从采集到再灌注的温度动态变化：静态冰冻与受控低温储存。

背景：缺血再灌注损伤（IRI）仍然是肺移植（LTx）的一个重要挑战。缺血可分为三个阶段：获取过程中的冷却、保存和植入过程中的再加热。温度波动影响代谢过程，加剧IRI。然而，实际的肺温度以前没有研究过。因此，我们的目的是表征静态冰储存（SIS）和控制低温储存（CHS）临床LTx的肺温度动态。方法：从2022年12月到2024年2月，我们在单中心纳入了35例SIS和19例CHS双侧LTx病例，结果是70例SIS和38例CHS个体肺。用热像仪测量表面温度（surfaceT°）。使用蓝牙温度计记录6个SIS和6个CHS的保存温度（preservationT°）。在开封后和植入期间每10分钟用柔性探针测量下肺叶支气管的核心温度（coreT°）。使用GraphPad （Prism 10）对人口统计学和结果进行分析。结果：冲洗前的平均±SD表面温度为30±3.3℃，提取后为17±4.1℃，包装前为8.6±3.3℃。保存时间98min后达到4℃，266min后达到0℃。拆封后，surfaceT°为1.8±2.3°C， coreT°为1.6±1.2°C。植入30min时，surfaceT°为25.0±2.9°C， coreT°为22.0±4.4°C。CHS表面温度为冲洗前30.0±2.5°C，提取后17±3.8°C，包装前11±3.5°C。拆封后，surfaceT°为7.9±2.0°C， coreT°为7.1±1.1°C。植入30min时，surfaceT°为26.0±1.7℃，coreT°为24.0±3.6℃。两组术后结果具有可比性。结论：我们描述了临床LTx的温度动态，揭示了肺冲洗引起的快速降温，SIS引起的潜在冻伤以及植入过程中的快速复温。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Heart and Lung Transplantation 医学-呼吸系统

CiteScore

10.10

自引率

6.70%

发文量

1667

审稿时长

69 days

期刊介绍： The Journal of Heart and Lung Transplantation, the official publication of the International Society for Heart and Lung Transplantation, brings readers essential scholarly and timely information in the field of cardio-pulmonary transplantation, mechanical and biological support of the failing heart, advanced lung disease (including pulmonary vascular disease) and cell replacement therapy. Importantly, the journal also serves as a medium of communication of pre-clinical sciences in all these rapidly expanding areas.