Lung thermography during the initial reperfusion period to assess pulmonary function in cellular ex vivo lung perfusion. Issue 8 (9th March 2022)

• Record Type: Journal Article
• Authors: Kosaka, Ryo; Sakota, Daisuke; Niikawa, Hiromichi; Ohuchi, Katsuhiro; Arai, Hirokuni; McCurry, Kenneth R.; Okamoto, Toshihiro
• Is Part Of: Artificial organs. Volume 46:Issue 8(2022)
• Page Start: 1522
• Page End: 1532
• Publication Date: 2022-03-09
• Subjects: lung assessment -- lung surface temperature -- lung transplantation -- rewarming phase; Artificial organs -- Periodicals; 617.956
• DOI: 10.1111/aor.14219
• Languages: English
• ISSNs: 0160-564X

Abstract

Abstract: Background: Thermography is a noninvasive technology to detect low temperatures in poorly circulated areas. In ex vivo lung perfusion (EVLP), lungs are rewarmed to body temperature during the initial 1 h. Currently, the effect of graft thermal changes during the rewarming phase on pulmonary function is unknown. In this study, we evaluated the correlation of lung surface temperature with physiological parameters, wet/dry ratio, and transplant suitability in Lund‐type EVLP. Methods: Fifteen pigs were divided into three groups: control group (no warm ischemia) or donation after circulatory death groups with 60 or 90 min of warm ischemia ( n = 5, each). Thermal images of the lower lobes were continuously collected from the bottom of an organ chamber using infrared thermography throughout EVLP. Results: At 8 min, lung surface temperatures of nonsuitable cases were significantly lower than in suitable cases (25.1 ± 0.6 vs. 27.8 ± 1.2°C, p < 0.001), while there was no difference in lung surface temperatures between the two groups at 0–4 min and 12–120 min. There was a significant negative correlation between lung surface temperatures at 8 min and wet/dry ratio at 2 h in the lower lobes ( R = −0.769, p < 0.001, cutoff = 26°C, area under the curve = 1.0). A lung surface temperature of <26°C was significantly correlated with poor pulmonary function and transplant nonsuitability. Conclusion: A lung surface temperature of ≥26°C at 8 min is a good early predictor of transplant suitability in cellular EVLP and might be applicable in clinical EVLP. Abstract : This study evaluated the correlation of lung surface temperatures with physiological parameters and transplant suitability in cellular ex vivo lung perfusion (EVLP). At 8 min, lung surface temperatures of nonsuitable cases were significantly lower than in suitable cases, while there was no difference in lung surface temperatures between the two groups at 0–4 min and 12–120 min. A lung surface temperature is a good early predictor of transplant suitability in cellular EVLP.