Long agonal period deteriorates cardiac death donor lung function in a rat EVLP model

  • Kyoko Hijiya
  • Toyofumi Fengshi Chen-YoshikawaEmail author
  • Hideki Motoyama
  • Akihiro Ohsumi
  • Daisuke Nakajima
  • Jin Sakamoto
  • Akihiro Aoyama
  • Hiroshi Date
Original Article



We investigated the impact of the duration of agonal period on donor lung function after reperfusion in an ex vivo rat lung perfusion model.


Three mechanical hypoventilation conditions were used for three agonal periods, which were defined as the interval between the start of hypoventilation and the time when systolic arterial blood pressure reached < 50 mmHg, i.e., < 10, 30–60, and 150–200 min for very short (VS), short (S), and long (L) groups (n = 5 rats/group). After flushing the lung, heart–lung blocks were reperfused ex vivo for 120 min; physiological data were obtained throughout the reperfusion process.


Pulmonary vascular resistance was significantly higher throughout reperfusion in group L than in the other two groups (p < 0.05). After reperfusion, oxygenation was worse and pulmonary edema was more severe in group L than in group S (p < 0.05). Potassium concentrations in the perfusates were significantly higher in group L than in group VS. Histological analysis revealed more severe injury in group L than in the other two groups.


Long agonal periods may lead to deterioration of donor lung function; short intervals may not significantly affect donor lung function.


Lung transplantation Controlled donation after cardiac death Agonal period Warm ischemic time Animal model 


Compliance with ethical standards

Conflict of interest

The authors declare no competing financial interest.


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Copyright information

© The Japanese Association for Thoracic Surgery 2018

Authors and Affiliations

  1. 1.Department of Thoracic Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan

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