Lung transplant, which often comes from brain dead (BD) donors, is the treatment of choice for severe lung disease. However the low numbers of viable lungs for transplantation impacts on the patient treatment capacity. Clinical and experimental studies highlight the impact of BD on lung viability for transplant, starting with the hemodynamic instability and inflammatory and immunological alterations. In order to improve organ quality, technics such as ex vivo lung perfusion has been used. At the same time, studies point to worse prognosis in lung transplants from female donors to male recipients. Also, previous results from our laboratory, using an experimental model of BD in rats, show a higher lung inflammation in female rats, associated with the acute reduction of female sex hormones. These findings together with clinical and experimental studies showing protective effects of estradiol on the immune system, lung inflammation and release of pro-inflammatory mediators, reinforce the importance of studying estradiol effects on the control of lung inflammatory response in female rats submitted to brain death. Therefore, this study intends to evaluate the effect of ex vivo lung perfusion with estradiol on BD female lungs. In that sense, the association between the ex vivo lung perfusion with a possible protective effect of estradiol could become a therapeutic alternative to mitigate the deleterious effects of brain death.
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