Protective Effects Of HPG Solution On Ischemia-reperfusion Injury Of Transplanted Lung

Objective: To explore the protective effect of HPG lung preservation solution on ischemia reperfusion injury of transplanted Lung.Methods: Thirty-two beagles were randomly divided into HPG group and LPD group,and paired up as donors and recipients(n=8).The pulmonary perfusion and preservation of donor lungs in the LPD group was performed with LPD solution,while that in the HPG group was performed with HPG solution.After 6 hours of cold storage,allograft left lung transplantation was performed.The index of lung function(MPAP、PCWP、ABG)、serum IL-6、TNF-α were detected at time points(pre-transplantation,2h、4h after transplantation).After 30min、2h、4h transplantation,lung compliance indicators(FSI、DPPC、TPL)and the white blood cell count in BALF were detected.The contents of MPO and MDA,expression levels of IL-1β mRNA and CINC mRNA and pathological changes of lung tissue were detected after 6h of cold storage and 2h after transplantation.After the operation,the animals were fed in a single cage and the survival days were recorded.Results: 1.There were no operation death in the whole group,and the transplanted dogs all survived successfully.After 14 days of observation,all the dogs in the HPG group survived,while one dog in the LPD group died on the 8th day due to bronchial disruption.2.There was no significant difference in MPAP,PCWP,lung compliance and oxygenation index before transplantation and 2h after reperfusion,while the HPG group was better than the LPD group after 4h reperfusion(p<0.05).FSI and DPPC/TPL were better in the HPG group than in the LPD group after reperfusion for 30 min,2h and 4h(p<0.05).3.There was no significant difference in the concentration of IL-6 and TNF-α before transplantation,while after reperfusion for 2h and 4h,the HPG group was lower than the LPD group(p<0.05).Expression levels of IL-1β mRNA and CINC mRNA were lower in the HPG group than in the LPD group at the time points of cold storage for 6h and reperfusion for 2h(p<0.05).The white blood cell count in BALF was lower in the HPG group than in the LPD group after reperfusion for 30 min,2h and 4h(p<0.05).The concentration of MPO and MDA in the HPG group were lower than that in the LPD group after cold storage for 6h and reperfusion for 2h(p<0.05).4.After 6h of cold storage,the lung structures in both groups were normal under light microscope,the alveolar septa was not wide,no obvious epithelial cell detachment and inflammatory cell infiltration were observed in the alveolar cavity.After 2h of reperfusion,little change was observed in the HPG group,while a small amount of fibrous exudation and inflammatory cell infiltration were observed in the LPD group,with slight edema in the alveolar space interval.5.The Pa O2 in the HPG group at 3d,7d and 12 d after transplantation was found to be superior to that in the LPD group(p<0.05).Conclusion: HPG solution has a better protective effect on ischemia-reperfusion injury of transplanted lung than LPD solution.