Combined VA-VPA ECMO for prompt recovery from primary graft dysfunction after lung transplantation

2023 Fiscal Year Final Research Report

• Project/Area Number: 22K20939
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund
• Review Section: 0905:Surgery of the organs maintaining homeostasis and related fields
• Research Institution: Okayama University
• Principal Investigator: Matsubara Kei 岡山大学, 医歯薬学総合研究科, 非常勤研究員 (00947947)
• Project Period (FY): 2022-08-31 – 2024-03-31
• Keywords: 肺移植 / 早期移植肺機能不全

Outline of Final Research Achievements

We used an experimental swine, and reconfirmed the process of thoracotomy, ECMO circuit introduction and formation. We determined suitable flow rate of combined-VA-VPA ECMO circuit. Then, we established an experimental swine PGD model by clamping left hilum of lung and reperfusion. We confirmed the availability of combined-VA-VPA ECMO circuit also in this PGD model. However, the PGD damage was too severe for experiment. Swine died after the end of ECMO treatment, so we couldn't assess the effectiveness of combined-VA-VPA ECMO. We need a little adjustment of experimental method. After that, the next plan is evaluation of combined-VA-VPA ECMO using an experimental swine lung transplantation model.

Free Research Field

肺移植

Academic Significance and Societal Importance of the Research Achievements

拡大基準ドナーからの臓器活用の観点では，摘出肺を移植する前に体外で人工呼吸器と独立肺循環回路につなぎ管理するEx vivo lung perfusion (EVLP)法が世界的に認められ，臨床応用に至っている．一方で移植術後のPGD発症をゼロにすることはできず，体内に移植されてしまったグラフト肺に対する治療手段には別の検討が求められるが，本研究はまさに術後治療戦略の観点に立った研究計画である．今後，本法の有用性が示され，PGDの新規治療戦略となり得れば，これまで使用を断念していた臓器の使用数増加や移植術後早期死亡の減少に寄与できるより強力な治療手段となる可能性がある．