Impact of normothermic regional perfusion during DCD recovery on lung allograft function: A preclinical study
Bibliographic record
Abstract
Normothermic Regional Perfusion (NRP) has been growing as a novel procurement strategy after circulatory death (DCD) in the context of heart transplantation. However, the impact of NRP on lung graft viability is largely unknown. We sought to determine lung function after thoraco-abdominal NRP (TA-NRP) in a clinically relevant porcine DCD model. Donor domestic pigs underwent hypoxic cardiac arrest to simulate DCD procurement and were randomly allocated to either 1-hour resuscitation on TA-NRP (n=4) or direct lung procurement (DPP, n=4). All lungs were placed on ex-vivo lung perfusion (EVLP) and evaluated for 3 hours to assess functional outcome parameters and suitability for transplantation. After 1 hour of TA-NRP, cardiopulmonary bypass was weaned, and mean systemic PO2/FiO2 was 418±76 mmHg, which was comparable to baseline (467±41, p=0.41). No significant differences were seen between the groups during EVLP, except for a higher pulmonary artery pressure in the TA-NRP group at 3 hours of EVLP (19.7±1.5 vs. 14.7±2.1 mmHg, p=0.02). Perfusate inflammatory cytokines levels of IL-6 and IL-8 were higher at the first hour of EVLP in the TA-NRP group; however, these differences were not sustained as levels were similar by the last hour of EVLP. There were no differences in histology, cytokines, or metabolic profile of the TA-NRP lungs compared to DPP. TA-NRP porcine lungs met functional criteria to proceed to transplantation and demonstrated no significant histological, cytokine and metabolic differences when compared to DPP porcine lungs. This study highlights the value of considering TA-NRP lungs for transplant with well-established protocols.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".