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Modified low-flow ultrafiltration ameliorates hemodynamics and early graft function and reduces blood loss in living-donor lobar lung transplantation

Research Project

Project/Area Number 18591704
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Anesthesiology/Resuscitation studies
Research InstitutionOkayama University

Principal Investigator

GOTO Keiji  Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Associate Professor (00234980)

Co-Investigator(Kenkyū-buntansha) DATE Hiroshi  Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Professor (60252962)
MIZOBUCHI Satoshi  Okayama University, Okayama University Hospital, Lecturer (70311800)
Project Period (FY) 2006 – 2007
Project Status Completed (Fiscal Year 2007)
Budget Amount *help
¥3,120,000 (Direct Cost: ¥2,700,000、Indirect Cost: ¥420,000)
Fiscal Year 2007: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
Fiscal Year 2006: ¥1,300,000 (Direct Cost: ¥1,300,000)
Keywordslung transplantation / reperfusion injury / lung injury / cardiopulmonary bypass / modified low-flow ultrafiltlation / 虚血再灌流 / 体外循環
Research Abstract

We have succeeded a living-donor lober lung transplantation (LDLLT) at Okayama University Hospital in 1998, which was the first lung transplantation (LT) in Japan. We performed LT in 57 critically ill patients (47 patients of LDLLT) from 1999 to 2007. Reperfusion lung injury (RLI) occurs following lung transplantation, and is a major post-operative complication. A major cause of the death is RLI and the treatment has not been established in LT. Inflammatory mediators play an important role in the modulation of reperfusion injury. LDLLT is generally performed with the use of cardiopulmonary bypass (CPB). CPB exacerbates inflammatory response in recipient and the reperfusion of grafts after CPB may deteriorate ischemia-reperfusion injury. Modified ultrafiltration (MUF) has been developed as an effective perfusion strategy to minimize the adverse effects of CPB in open heart surgery. MUF may modulate systemic inflammatory mediators and inprove hemoddynamics and graft function after LT. No … More report of the effectiveness of MUF in LT has shown. We measure intraoperative levels of key cytokines and polymorphonuclear elastase (PMN-E) in plasma in patients undergoing LDLLT surgery with CPB. This study analyzed the clinical application of MUF to minimize cardiopulmonary bypass (CPB)-related lung injury in patients undergoing LDLLT.
LT patients demonstrated significant elevations of IL-6 and PMN-E during and after CPB. IL-6 production increased significantly after CPB. Ischemic and CPB time did not correlate with IL-6 and PMN-E levels. Our data suggest that production of inflammatory cytokines and mediators are triggered by CPB and that production of IL-6 is accelerated by reperfusion of lung grafts after CPB. MUF did not inhibit the increase of serum IL-6 level, nor decrease IL-8 and PMN-E levels. MUF brought improved hemodynamics and gas exchange capacity of transplanted grafts and lowered post-operative blood loss and blood transfusion requirement. This strategy may minimize CPB-related adverse effects in patients undergoing LDLLT. Less

Report

(3 results)
  • 2007 Annual Research Report   Final Research Report Summary
  • 2006 Annual Research Report
  • Research Products

    (10 results)

All 2009 2008 2007

All Journal Article (5 results) (of which Peer Reviewed: 3 results) Presentation (5 results)

  • [Journal Article] Modified low-flow ultrafiltration ameliorates hemodynamics and early graft function and reduces blood loss in living-donor lobar lung transplantation2009

    • Author(s)
      Yasuhiro Kotani, Osami Honjo, Keiji Goto, et al.
    • Journal Title

      The Journal of Heart and Lung Transplantation 28

      Pages: 340-346

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2007 Final Research Report Summary
    • Peer Reviewed
  • [Journal Article] Modified low-flow ultrafiltration ameliorates hemodynamics and early graft function and reduces blood loss in living-donor lobar lung transplantation.2009

    • Author(s)
      Yasuhiro Kotani, Osami Honjo, Keiji Goto, et al
    • Journal Title

      The Journal of Heart and Lung Transplantation 28

      Pages: 340-346

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2007 Final Research Report Summary
  • [Journal Article] Living-donor lobar lung transplantation for pulmonary arterial hypertension after failure of epoprostenol therapy2007

    • Author(s)
      Hiroshi Date, Keiji Goto, et al.
    • Journal Title

      J Am Coll Cardiol 50

      Pages: 523-527

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2007 Final Research Report Summary
    • Peer Reviewed
  • [Journal Article] Living-donor lobar lung transplantation for pulmonary arterial hypertension after failure of epoprostenol therapy2007

    • Author(s)
      Hiroshi Date, Keiji Goto, et al
    • Journal Title

      J Am Coll Cardiol 50

      Pages: 523-527

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2007 Final Research Report Summary
  • [Journal Article] Living-donor lobar lung transplantation for pulmonary arterial hypertension after failure of epoprostenol therapy2007

    • Author(s)
      Date H, Goto K, et. al.
    • Journal Title

      J Am Coll Cardiol 50

      Pages: 523-527

    • Related Report
      2007 Annual Research Report
    • Peer Reviewed
  • [Presentation] Perioperative management and improved survival of living-donor lobar lung transplantation2008

    • Author(s)
      Keiji Goto, Moritoki Egi, Motohiko Hanazaki, et al.
    • Organizer
      American Society of Anesthesiologists
    • Place of Presentation
      米国オーランド
    • Year and Date
      2008-10-20
    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2007 Final Research Report Summary
  • [Presentation] Perioperative management and improved survival of living-donor lobar lung transplantation.2008

    • Author(s)
      Keiji Goto, Moritoki Egi, Motohiko Hanazaki, et al.
    • Organizer
      American society of Anesthesiologists 2008 Annual Meeting
    • Place of Presentation
      Orland USA
    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2007 Final Research Report Summary
  • [Presentation] Hypercapnia after induction of anesthesia for ptients with severe idiopa thic interstitial pneumonia2007

    • Author(s)
      Asako Yamashita, Keiji Goto, et al.
    • Organizer
      American Society of Anesthesiologists
    • Place of Presentation
      米国サンフランシスコ
    • Year and Date
      2007-10-14
    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2007 Final Research Report Summary
  • [Presentation] Hypercapnia after induction of anesthesia for ptients with severe idiopathic interstitial pneumonia2007

    • Author(s)
      Yamashita A, Goto K, et. al.
    • Organizer
      米国麻酔学会(American Society of Anesthesiologists)
    • Place of Presentation
      米国サンフランシスコ
    • Year and Date
      2007-10-14
    • Related Report
      2007 Annual Research Report
  • [Presentation] Hypercapnia after induction of anesthesia for ptients with severe idiopathic interstitial pneumonia2007

    • Author(s)
      Asako Yamashita, Keiji Goto, et al.
    • Organizer
      American society of Anesthesiologists 2007 Annual Meeting
    • Place of Presentation
      San Francisco USA
    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2007 Final Research Report Summary

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Published: 2006-04-01   Modified: 2016-04-21  

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