Protective effects of ulinastatin on ischemia-reperfusion injury during rat non-heart beating donor lung transplantation / 中华器官移植杂志

ABSTRACT

Objective To investigate the protective effects of ulinastatin (UTI) on ischemiareperfusion injury of donor lungs,and the possible mechanism.Method Forty male SD rats were randomly divided into two groupsgroup C as control group and group U as UTI group.In group C donor lungs were antegradely flushed with 20 ml of cold (4 C) low potassium dextron (LPD) solution and 5 ml retrogradely.Meanwhile,in group U,UTI (500 000 U/L) was added in LPD solution and the same doses were used.According to the time after initiation of reperfusion,each group was divided into two subgroups30 min (subgroup A) and 1 h (subgroup B).Arterial blood samples were collected for blood gas analysis.Lung samples were obtained at the end of reperfusion (30 min or 1 h).Microscopic examination of the donor lungs was conducted.Besides,the pulmonary water index (W/D),tissue malondialdehyde (MDA) and superoxide dismutase (SOD) content,and mRNA expression of tumor necrosis factor (TNF-a),intercellular adhesion molecule 1 (ICAM-1) and interleukin 10 (IL-10) were also measured.Results (1) One h after reperfusion,oxygenation index in group U was higher than that in group C (P =0.025) ; (2) The levels of W/D in subgroup A and subgroup B of group U were decreased as compared with group C (P =0.005 and P =0.006) ; (3)The microscopic changes of donor lung tissues in group U were lessen than in group C; (4) In subgroup A of group U,MDA content was decreased (P=0.039),and SOD content was increased (P=0.035),and similar results could be observed in subgroup B of group U (P =0.006 and P =0.030 respectively); (5) As compared with group C,the mRNA expression of TNF-α in group U was decreased at the time of 30 min after reperfusion (P =0.000),but no significant change was found at the time of 1 h (P =0.139).The mRNA expression of ICAM-1 was not decreased evidently at the time of 30 min (P=0.062),but significantly decreased at the time of 1 h (P=0.001).The mRNA expression of IL-10 was increased in subgroups A and B (P =0.004 and P =0.000 respectively).Conclusion This study demonstrated that UTI had protective effects of reducing ischemia-reperfusion injury on the donor lungs after lung transplantation in rat non-heart beating donor models.