The following is a summary of “Identification of regional variation in gene expression and inflammatory proteins in donor lung tissue and ex vivo lung perfusate,” published in the December 2023 issue of Surgery by Chao, et al.
In lung transplantation, one of the challenges is making a diagnosis of lung damage. The question of whether or not a single biopsy specimen is genuinely typical of the complete organ has yet to be answered. Ex vivo lung perfusion perfusate and human lung tissue samples were used to determine the presence of inflammatory biomarkers in the lungs. Eight human donor lungs not selected for transplantation were examined during air inflation, flash freezing, and partitioning from apex to base. After that, blood samples were taken from various parts of the lung. Ex vivo lung perfusion was performed on eight more donor lungs, and perfusate was collected from four lung lobes used in the procedure.
The levels of interleukin-6, interleukin-8, interleukin-10, and interleukin-1β were determined by using quantitative reverse transcription polymerase chain reaction (RT-PCR) from lung biopsies and enzyme-linked immunosorbent assay (ELISA) from ex vivo lung perfusion perfusate. For messenger RNA biomarkers in tissue biopsies, the median intra-biopsy equal-variance (P=50). This value was taken from the biopsy. The intra-biopsy coefficient of variation was estimated to be 18% on average. There was no discernible difference in the lung slices of each donor, with a coefficient of variation of 20%, when the biopsies were performed on donors who did not seem to have any focal damage. The only exceptions to the rule were biopsies taken from the lingula and wounded focal regions, which revealed more significant changes. The coefficient of variance for cytokines in ex vivo lung perfusion perfusate was 4.9%, indicating very little variation across the various lobes.
The expression of cytokine genes in lung biopsies was consistent, and the outcome of the biopsy analysis was representative of the whole lung, except in cases in which specimens were taken from the lingula or a region of focused damage. An additional benefit of using ex vivo lung perfusion perfusate is that it offers a representative assessment of lung inflammation from the draining lobe level. For doctors, the findings provided reassurance that a lung biopsy or an ex vivo lung perfusion perfusate sample may be used to provide information on the selection of donor lungs.
Source: sciencedirect.com/science/article/abs/pii/S0022522323006189