Histopathological evaluation of transplanted lungs in a post-brain death, post-circulatory arrest or cold ischemia donation model

• Grant number: 21/14175-3
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: February 01, 2022
• End date: December 31, 2022
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Paulo Manuel Pêgo-Fernandes
• Grantee: Giovana Maria Manzuti
• Host Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Currently, the main types of donations accepted in major world centers are Donation after Brain Death (DBD) and Donation after Circulatory Death (DCD). Nonetheless, we know that the demand for lung transplants is high, and with each passing year, the rate of these transplants decreases. Donation after brain death (BD) is the major source of LT, and only 10 to 30% of the lungs offered are viable. In the evolution of the BD process, there is a cascade of hemodynamic, metabolic, inflammatory, and neuroendocrine events that cause damage to lung tissue. These events are directly related to the development of primary graft dysfunction (PGD) after LT. The number of DCD capitation has been growing in major centers around the world, with the aim of reducing the waiting time of patients on the list. Complications associated with DCD are related to the period of warm ischemia that occurs between the suspension of life-sustaining support and lung uptake by the transplant team. The results obtained in recent years using DCD are promising and with survival comparable to those of patients transplanted from DBD. Since experimental models are widely used in experimental research on transplantation, the aim of these studies is to describe and compare the inflammatory process after lung transplantation using donation after brain death; donation after circulatory arrest, and cold ischemia. Based on these results, it is possible to provide important data to the literature so that researchers in the field of lung transplantation can standardize and choose models that are more compatible with specific treatments. Twelve rats will be used, which will be divided into 4 groups: Intact (n=3); Brain Death (n=3); Circulatory stop (n=3); Cold Ischemia (n=3). At the end of the protocol, the histopathology of lung tissue and evaluation of pulmonary edema will be evaluated.(AU)