Peri-op Respiratory Failure After Lung Transplantation
Research type
Research Study
Full title
A Perioperative study of lung transplantation and acute respiratory failure.
IRAS ID
125520
Contact name
Anna Reed
Contact email
Sponsor organisation
Royal Brompton & Harefield NHS Foundation Trust
Research summary
Background:
Acute respiratory failure (ARF) is common following lung transplantation and there are numerous potential causes:1) Transplanted lungs are injured following the interruption to their blood supply as they are retrieved from the donor. As blood flow is restored during donor implantation, the sudden flow of oxygen to the injured lungs can result in further damage.
2) Patients require breathing support from a ventilator on the Intensive Care Unit (ICU) while they recover from their lung transplant procedure. The ventilator assists breathing by blowing air into the lungs with positive pressure. Despite being used to help patients with acute respiratory failure, this pressure on the lung can add an additional insult to the injured lungs, and thus further exacerbate ARF (Termed Ventilator Associated Lung Injury - VALI).
3) Transplant recipients are immunosuppressed to reduce the of risk rejection, but rejection remains a potential cause of ARF.
4) Immunosuppression renders the lung transplant recipient vulnerable to opportunistic infections, which may also cause respiratory failure.
Hypothesis
Oxidative stress contributes to lung injury in non-transplanted patients. It likely that oxidative stress also plays an important role in the multiple causes of respiratory failure in lung transplant recipients.Aims
We will quantify the effects of oxidative stress on the development of ARF following lung transplantation.
To quantify the systemic effects of oxidative stress following transplantation.Methodology
We will conduct a single-centre observational pilot study of patients undergoing double-lung transplantation. We will measure multiple markers of oxidative stress that have been utilised in other patient groups, and attempt to validate their use within the lung transplant population. We will then assess the impact of this oxidative stress on lung physiology.Implications
This study will provide valuable information on the mechanisms of respiratory failure following transplantation and potentially validate new tools for monitoring lung injury.REC name
London - Riverside Research Ethics Committee
REC reference
13/LO/1052
Date of REC Opinion
16 Aug 2013
REC opinion
Favourable Opinion