ORIGINAL RESEARCH article
Front. Transplant.
Sec. Thoracic Transplantation
Volume 4 - 2025 | doi: 10.3389/frtra.2025.1651671
Ischemia-reperfusion injury with a model of Porcine Whole-Blood Ex-Vivo Lung Perfusion
Provisionally accepted
Jean Baptiste Menager1*
Julia Mercier1
Justin Issard1maria rosa ghigna2jeanne tran van nhieu3benoit decante1
julien guihaire1Elie FAdel1
fabrice antigny1
Olaf Mercier1*- 1Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- 2Institut Gustave Roussy, Villejuif, France
- 3Hôpitaux Universitaires Henri Mondor, Créteil, France
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Our objective was to model Ischemia-Reperfusion (IR) injuries by ex-vivo perfusion of porcine lungs with whole blood containing the inflammatory cells. Lungs and whole blood were collected from 12 pigs and submitted to cold ischemia time (CIT) of 1 or 18 hours. The lungs were then ventilated and perfused for 6 hours at 37°C using donor whole blood.Pulmonary pressure was 20 mmHg.Compared to the short CIT group, the long CIT group had a lower maximum perfusion flow rate (mean difference in % cardiac output, -39%; 95%CI, -66 to -12; P=0.005) and higher pulmonary vascular resistance (mean difference, 1077 dyne•s•cm -⁵; 95%CI, 685-1469; P<0.001). Neutrophils decreased more in the long CIT group (mean difference, -744.02 cells/mm³; 95%CI, -1343.11 to -144.92; P=0.017), suggesting sequestration in the lung parenchyma. Interleukin-6 and -8 levels after 6 hours were significantly higher in the long CIT group (mean differences, 1.1 pg/mL; 95%CI, 0.39-1.8; P=0.003; and 29.31 pg/mL; 95%CI, 16.00-42.61; P<0.001; respectively). Progressive microvasculopathy resulting in lymphangiectasia and peribronchovascular inflammatory infiltrates were seen in both groups.After 18 hours of CIT, ex-vivo whole-blood perfusion for 6 hours replicated features of IR injuries.
Keywords: Ischemia-reperfusion, animal model, Organ perfusion, lung transplant, Primary Graft Dysfunction
Received: 22 Jun 2025; Accepted: 11 Aug 2025.
Copyright: © 2025 Menager, Mercier, Issard, ghigna, tran van nhieu, decante, guihaire, FAdel, antigny and Mercier. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jean Baptiste Menager, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
Olaf Mercier, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
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