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Mechanisms of lung ischemia-reperfusion injury

Laubach, Victor E.; Sharma, Ashish K.

Current Opinion in Organ Transplantation: June 2016 - Volume 21 - Issue 3 - p 246–252
doi: 10.1097/MOT.0000000000000304
Review
Editor's Choice

Purpose of review Lungs are extremely susceptible to injury, and despite advances in surgical management and immunosuppression, outcomes for lung transplantation are the worst of any solid organ transplant. The success of lung transplantation is limited by high rates of primary graft dysfunction because of ischemia-reperfusion injury characterized by robust inflammation, alveolar damage, and vascular permeability. This review will summarize major mechanisms of lung ischemia-reperfusion injury with a focus on the most recent findings in this area.

Recent findings Over the past 18 months, numerous studies have described strategies to limit lung ischemia-reperfusion injury in experimental settings, which often reveal mechanistic insight. Many of these strategies involved the use of various antioxidants, anti-inflammatory agents, mesenchymal stem cells, and ventilation with gaseous molecules. Further advancements have been achieved in understanding mechanisms of innate immune cell activation, neutrophil infiltration, endothelial barrier dysfunction, and oxidative stress responses.

Summary Methods for prevention of primary graft dysfunction after lung transplant are urgently needed, and understanding mechanisms of ischemia-reperfusion injury is critical for the development of novel and effective therapeutic approaches. In doing so, both acute and chronic outcomes of lung transplant recipients will be significantly improved.

Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, USA

Correspondence to Victor E. Laubach, PhD, Department of Surgery, University of Virginia School of Medicine, PO Box 801359, Charlottesville, VA 22908, USA. Tel: +1 434 924 2927; e-mail: laubach@virginia.edu

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