Date: Monday, May 4, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Within INSPIRE trial standard cold storage (SOC) is compared to normothermic, ventilated donor lung preservation (Organ-Care-System®, OCS). As lung preservation may influence immune mediators (IM), thereby clinical outcome, lympohcyte subsets and cytokines released from lungs into perfusion solutions (PS) and peripheral blood (PB) were analysed.
From 31 OCS and 23 SOC patients, IM and T cell subsets were analysed in PS and PB by multiplex and FACS-analyses. Clinical outcome, donor and recipient demographics were assessed.
Clinical evaluation revealed (OCS vs SOC): mean donor age 44 vs. 48 years, mean recipient age 50 vs. 50 years, underlying diagnosis: idiopathic fibrosis (n=15 vs n=11), cystic fibrosis (n=7 vs n=6), idiopathic pulmonary hypertension (n=2 vs n=2) and emphysema (n=7 vs n=4). Mean cross clamp times for right (434 vs 421 min) and left lung (563 vs. 537) did not differ significantly. Higher %predicted FEV1 at discharge was recorded in the OCS group (68% vs 60%), as well as higher paO2/FiO2 ratio at T0 (367 vs 321). Lymphocytes were mobilized into PS in both groups with significant differences of higher proportions of CD3+CD8+ T cells and CD3+CD4+CD56+ T helper cells in OCS. Presence of CD56+ Th cells in OCS PS correlated with Th2 cytokines, which were dominated by IL-4, IL-10, IL-31 and sCD40L as activation markers and induced by IL-33. This anti-inflammatory Th2 response maintained also in OCS recipients suppressing IL-6 mediated inflammation post Tx. Since high IL-6 levels in plasma of SOC patients post Tx negatively correlated with PaO2/FiO2 ratio, suppression of IL-6 by Th2 cells and their cytokines represents an important mechanism for improved immune status of OCS preserved lungs.
Immediate OCS preservation generates an anti-inflammatory Th2 milieu, induced by IL-33 production of lung epithelial cells and suppresses inflammation after Tx. It also changes lymphocyte and cytokine release from the lungs towards a tissue-protective milieu associated with lower immunogenicity seen by their different T cell compositions. Since several factors correlated with lung function, they may represent biomarker candidates for clinical outcome.
To cite this abstract in AMA style:Wiegmann B, Falk C, Seyda M, Neudörfl C, Akhdar A, Kühn C, Tudorache I, Avsar M, Haverich A, Warnecke G. Donor Lung Preservation With the Organ Care System® Promotes a Tissue Protective and Anti-Inflammatory Response During Transplantation [abstract]. Am J Transplant. 2015; 15 (suppl 3). http://atcmeetingabstracts.com/abstract/donor-lung-preservation-with-the-organ-care-system-promotes-a-tissue-protective-and-anti-inflammatory-response-during-transplantation/. Accessed December 18, 2017.
« Back to 2015 American Transplant Congress