Incidence of primary graft dysfunction after lung transplantation is altered by timing of allograft implantation
- Resource Type
- Authors
- Cunningham, P; Maidstone, R; Durrington, H; Venkateswaran, R; Cypel, M; Keshavjee, S; Gibbs, J; Loudon, A; Chow, C; Ray, D; Blaikley, J
- Source
- Thorax
Cunningham, P, Maidstone, R, Durrington, H, Venkateswaran, R, Cypel, M, Keshavjee, S, Gibbs, J, Loudon, A, Chow, C W, Ray, D & Blaikley, J 2018, ' Incidence of Primary graft dysfunction after lung transplantation is altered by timing of allograft implantation ', Thorax, vol. 74, no. 4, pp. 413-416 . https://doi.org/10.1136/thoraxjnl-2018-212021
- Subject
- Adult
Male
Mice, Knockout
Time Factors
Organ Preservation
respiratory system
Middle Aged
Brief Communication
Tissue Donors
Transplant Recipients
macrophage biology
Risk Factors
Circadian Clocks
Macrophages, Alveolar
Nuclear Receptor Subfamily 1, Group D, Member 1
lung transplantation
Animals
Humans
Female
Primary Graft Dysfunction
Aged
Retrospective Studies
- Language
- English
The importance of circadian factors in managing patients is poorly understood. We present two retrospective cohort studies showing that lungs reperfused between 4 and 8 AM have a higher incidence (OR 1.12; 95% CI 1.03 to 1.21; p=0.01) of primary graft dysfunction (PGD) in the first 72 hours after transplantation. Cooling of the donor lung, occurring during organ preservation, shifts the donor circadian clock causing desynchrony with the recipient. The clock protein REV-ERBα directly regulates PGD biomarkers explaining this circadian regulation while also allowing them to be manipulated with synthetic REV-ERB ligands.