Inflammatory response following DCD and DBD lung transplantation

Introduction. Donation after cardiac death (DCD) is emerging as a suitable solution to the shortage of grafts for lung transplantation (LTx). The inflammatory response between LTx utilising DCD and brain death donor (DBD) lungs has not been fully elucidated. Here we focus on leukocyte responses and release of permeability and oxidative stress mediators. Methods. Leukocyte kinetics were evaluated retrospectively in 63 DCD and 158 DBD recipients undergoing LTX between 2010-15. Plasma levels of Myeloperoxidase (MPO) and Heparin Binding Protein (HBP) were measured prospectively in 40 patients at baseline and at 0, 6, 12, 24, 48, and 72 hours after LTx by ELISA. Results. Total leukocyte and neutrophil counts and CRP but not lymphocyte and monocyte counts were significantly higher following DCD LTx. Figure 1 shows plasma release of HBP and MPO in the DCD and DBD groups. Severe Ischemia Reperfusion Injury (IRI) (defined by PF ratio Conclusions. Recipients of DCD lungs exhibit higher leucocytosis and neutrophilia following LTx but overall there is comparable neutrophil mediator release between groups. IRI is associated with increased MPO release suggesting a role of oxidative stress.