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In-vivo lung perfusion as a novel treatment strategy for primary graft dysfunction after lung transplantation

Research Project

Project/Area Number 21K08882
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 55040:Respiratory surgery-related
Research InstitutionOkayama University

Principal Investigator

Miyoshi Kentaroh  岡山大学, 大学病院, 助教 (50534773)

Co-Investigator(Kenkyū-buntansha) 杉本 誠一郎  岡山大学, 大学病院, 准教授 (40570148)
岡崎 幹生  岡山大学, 医歯薬学域, 准教授 (50467750)
Project Period (FY) 2021-04-01 – 2024-03-31
Project Status Completed (Fiscal Year 2023)
Budget Amount *help
¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000)
Fiscal Year 2023: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2022: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2021: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Keywords肺移植 / 早期移植肺機能不全 / In vivo lung perfusion / Ex vivo lung perfusion / PGD / Lung transplantation / IRI / lung transplantation / 体内肺還流システム / 臓器治療 / 虚血再還流障害 / 体内肺還流法
Outline of Research at the Start

肺移植後のPrimary graft dysfunction(PGD)に対してレシピエント体内で機能回復を図り、移植肺を生着させるという新規の概念を打ち立て、治療的移植肺還流技術を用いたIn vivo lung recovery (IVLR) 法を考案した。本研究では、動物実験として中動物(ブタ)を使用し、①肺移植再還流後の術野にてIVLR 回路を確立する技術を開発し、②虚血侵襲を加えたグラフト肺を移植することで生ずるPGDモデルに対しIVLR法の治療効果を実証する。

Outline of Final Research Achievements

Treatment options for early primary graft dysfunction (PGD) after lung transplantation are mainly limited to supportive measures like extracorporeal membrane oxygenation (ECMO). In this study, we explored the efficacy of a novel in vivo lung perfusion (IVLP) method as an early treatment for PGD. We established a porcine model for left lung transplant PGD and divided it into three groups for comparative analysis: untreated, ECMO-treated, and IVLP-treated. After confirming PGD onset, a two-hour treatment was administered. The IVLP-treated group demonstrated significant functional improvement in the transplanted lung, evidenced by both physiological and histological assessments. Our findings indicate that IVLP could be a promising therapeutic approach for PGD following lung transplantation.

Academic Significance and Societal Importance of the Research Achievements

本研究は移植前に体外でドナー肺の機能評価、治療を行うEx vivo lung perfusion (EVLP)の技術を移植後のレシピエント体内に応用したIVLPによってPGDの新規治療戦略としての有用性を検討するものである。EVLPはPGD管理に対して臨床応用されている唯一の手段である一方、高コスト、適応基準に明確なコンセンサスがないために過剰適応されうるといった問題がある。IVLPは移植後にPGDが実際に発症したことを確認した後に治療介入するものであり、必要症例にのみ適応できる利点を有している。
本研究成果は、拡大基準ドナー肺の使用数増加やPGD後の予後改善に寄与する戦略を提供するものである。

Report

(4 results)
  • 2023 Annual Research Report   Final Research Report ( PDF )
  • 2022 Research-status Report
  • 2021 Research-status Report
  • Research Products

    (5 results)

All 2024 2023 2022

All Journal Article (1 results) (of which Peer Reviewed: 1 results) Presentation (4 results) (of which Int'l Joint Research: 2 results)

  • [Journal Article] In vivo lung perfusion for prompt recovery from primary graft dysfunction after lung transplantation2024

    • Author(s)
      Matsubara Kei、Miyoshi Kentaroh、Kawana Shinichi、Kubo Yujiro、Shimizu Dai、Tomioka Yasuaki、Shiotani Toshio、Yamamoto Haruchika、Tanaka Shin、Kurosaki Takeshi、Ohara Toshiaki、Okazaki Mikio、Sugimoto Seiichiro、Matsukawa Akihiro、Toyooka Shinichi
    • Journal Title

      The Journal of Heart and Lung Transplantation

      Volume: 43 Issue: 2 Pages: 284-292

    • DOI

      10.1016/j.healun.2023.10.011

    • Related Report
      2023 Annual Research Report
    • Peer Reviewed
  • [Presentation] A novel strategy 'In vivo lung recovery' for prompt recovery for primary graft dysfunction after lung transplantation2023

    • Author(s)
      Kei Matsubara, Kentaroh Miyoshi, Takeshi Kurosaki, Shinichi Kawana, Yujiro Kubo, Dai Shimizu, Kohei Hashimoto, Shin Tanaka, Mikio Okazaki, Seiichiro Sugimoto, Shinichi Toyooka
    • Organizer
      The International Society for Heart and Lung Transplantation 2023 Annual Meeting and Scientific Sessions
    • Related Report
      2023 Annual Research Report
    • Int'l Joint Research
  • [Presentation] A novel strategy ‘In Vivo Lung Recovery’ for prompt recovery from primary graft dysfunction after lung transplantation2023

    • Author(s)
      Kei Matsubara, Kentaroh Miyoshi, Takeshi Kurosaki, Shinichi Kawana, Yujiro Kubo, Dai Shimizu, Hiroshi Taka, Kohei Hashimoto, Shin Tanaka, Mikio Okazaki, Seiichiro Sugimoto, Shinichi Toyooka
    • Organizer
      THE INTERNATIONAL SOCIETY FOR HEART AND LUNG TRANSPLANTATION 42nd Annual Meeting & Scientific Session
    • Related Report
      2022 Research-status Report
    • Int'l Joint Research
  • [Presentation] Ex vivo lung perfusion技術を体内へ応用したIn vivo Lung Recoveryによる新規治療戦略2022

    • Author(s)
      松原慧,三好健太郎,黒﨑毅史,川名伸一,久保友次郎,清水大,橋本好平,田中真,岡﨑幹生,杉本誠一郎,豊岡伸一
    • Organizer
      第58回日本移植学会総会
    • Related Report
      2022 Research-status Report
  • [Presentation] 肺移植後Primary Graft Dysfunctionに対する新規治療戦略 In vivo Lung Recovery (IVLR)の開発2022

    • Author(s)
      松原慧,三好健太郎,黒﨑毅史,川名伸一,久保友次郎,清水大,橋本好平,田中真,岡﨑幹生,杉本誠一郎,豊岡伸一
    • Organizer
      第75回日本胸部外科学会
    • Related Report
      2022 Research-status Report

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Published: 2021-04-28   Modified: 2025-01-30  

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