Ischemic Postconditioning Reduces Ischemic Reperfusion Injury of Non-Heart-Beating Donor Grafts in a Rat Lung Transplant

Objectives: This study was designed to see if ischemic postconditioning could attenuate ischemic reperfusion injury of transplanted lungs recovered from non-heart-beating donors. Materials and Methods: Forty Sprague-Dawley rats were randomized into 2 groups: the control group and the ischemic postconditioning group, with 10 donor rats paired with 10 recipient rats in each group. Twenty rats underwent a left lung transplant from non-heart-beating donors with a warm ischemia time of 36.7 +/- 5.62 minutes. In the ischemic postconditioning group, 5 cycles of 1-minute reperfusion and 1-minute reocclusion at the onset of reperfusion were applied as postconditioning. Arterial blood gas, wet-to-dry lung weight ratio, activities of malondialdehyde and superoxide dismutase, and expressions of apoptosis and ICAM-1 mRNA were compared. Results: When compared with the control group 4 hours after reperfusion, PaO2 was higher, and wet-to-dry lung weight ratio was lower, in the ischemic postconditioning group, and expression of apoptosis and ICAM-1 mRNA as well as activity of malondialdehyde were lower, while superoxide dismutase activity was higher in the ischemic postconditioning group. Conclusions: Ischemic postconditioning can reduce ischemic reperfusion injury of lungs recovered from non-heart-beating donors and preserve lung function by reducing reactive oxygen species and inhibiting apoptosis and inflammation.