The role of neural and vasoactive mediators in the regulation of the pulmonary circulation during cardiopulmonary preservation

J. P. Mashburn, G. J. Kontos, K. Hashimoto, D. M. Wilson, Hartzell V Schaff

Research output: Contribution to journalArticle

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Abstract

The autoperfused working heart-lung preparation has been used for extended cardiopulmonary preservation for transplantation. However, acute lung injury and failure of the preparation can result from pulmonary hypertension, which previous investigators have linked to denervation. We studied the neural and vasoactive mediators of pulmonary vasoconstriction during normothermic autoperfusion of the heart and lungs from 13 calves. Pulmonary vascular resistance was quantitated by multipoint pulmonary artery pressure/flow plots generated by incremental reduction in venous return at three times: A, after sternotomy but before autoperfusion (control); B, during in situ autoperfusion (innervated heart-lung preparation); and C, after explanation (denervated heart-lung preparation). During hemodynamic measurements, left atrial blood samples were obtained for measurement of thromboxane B2, 6-keto-prostaglandin-F(1α), and complement activation products C3a and C5a. Results show that pulmonary hypertension in the autoperfused working heart-lung preparation begins during autoperfusion before denervation and may be related to complement activation and to increased levels of circulating thromboxane B2 and 6-keto-prostaglandin F(1α) (both the absolute levels and the ratio of thromboxane B2 to 6-keto-prostaglandin F(1α)). After denervation, both prostaglandin intermediates were markedly increased, but their ratio was not significantly affected. These data suggest that there is an initial stage of pulmonary vasoconstriction at the onset of autoperfusion that is accompanied by increased circulating levels of vasoactive mediators and that denervation further contributes to this response.

Original languageEnglish (US)
Pages (from-to)434-443
Number of pages10
JournalJournal of Thoracic and Cardiovascular Surgery
Volume98
Issue number3
StatePublished - 1989

Fingerprint

Pulmonary Circulation
Lung
Denervation
Thromboxane B2
Prostaglandins F
Complement Activation
Vasoconstriction
Pulmonary Hypertension
Sternotomy
Acute Lung Injury
Vascular Resistance
Pulmonary Artery
Prostaglandins
Transplantation
Hemodynamics
Research Personnel
Pressure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

The role of neural and vasoactive mediators in the regulation of the pulmonary circulation during cardiopulmonary preservation. / Mashburn, J. P.; Kontos, G. J.; Hashimoto, K.; Wilson, D. M.; Schaff, Hartzell V.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 98, No. 3, 1989, p. 434-443.

Research output: Contribution to journalArticle

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