Systemic Inflammation Differences in Brain-vs. Circulatory-Dead Donors: Impact on Lung Transplant Recipients
Introduction: Systemic Inflammation Differences in Brain-vs. Circulatory-Dead Donors: Impact on Lung Transplant Recipients
The extent of this systemic inflammation in lung donors after brain death (DBD) compared to circulatory death (DCD) is unclear, yet it may significantly impact the incidence of primary graft dysfunction (PGD) following lung transplantation.
Brain death triggers a systemic inflammatory response.
Understanding these differences is crucial for improving outcomes in lung transplant recipients.
Study Overview and Methodology
We compared the plasma levels of interleukin (IL)-6, IL-8, IL-10 and TNF-α in BDB and DCD and their respective recipients, as well as their relationship with PGD and mortality after LT.
A prospective, observational, multicenter, comparative, cohort-nested study that included 40 DBD and 40 DCD lung donors matched and their respective recipients.
Relevant clinical information and blood samples were collected before/during lung retrieval in donors and before/during/after (24, 48 and 72 h) LT in recipients.
Incidence of PGD and short-term mortality after LT was recorded.
Key Findings on Cytokine Levels
Plasma levels of all determined cytokines were numerically higher in DBD than in DCD donors and reached statistical significance for IL-6, IL-10 and IL-8.
Conclusion: DBD is associated with higher systemic inflammation than DCD donors and TNF-α plasma levels
In recipients with PGD the donor’s plasma levels of TNF-α were higher.
The post-operative mortality rate was very low and similar in both groups.
DBD is associated with higher systemic inflammation than DCD donors, and higher TNF-α plasma levels in donors are associated with a higher incidence of PGD.
Authors
Alberto Sandiumenge, Irene Bello, Elisabeth Coll-Torres, Aroa Gomez-Brey, Clara Franco-Jarava, Eduardo Miñambres, Marina Pérez-Redondo, Fernando Mosteiro, Laura Sánchez-Moreno, Silvana Crowley, Eva Fieira, Borja Suberviola, Cristopher Alan Mazo, Alvar Agustí, Teresa Pont
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