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Platelet activation in the postoperative period after lung transplantation

Sternberg, David I.; Shimbo, Daichi; Kawut, Steven M.; Sarkar, Joydeep; Hurlitz, Georg; D’Ovidio, Frank; Lederer, David J.; Wilt, Jessie S.; Arcasoy, Selim; Pinsky, David J.; D’Armiento, Jeanine M.; Sonett, Joshua R.

Objective
During lung transplantation, cells in the pulmonary parenchyma are subjected to ischemia, hypothermic storage, and reperfusion injury. Platelets, whose granular contents include adhesion receptors, chemokines, and coactivating substances that activate inflammatory and coagulant cascades, likely play a critical role in the lung allograft response to ischemia and reperfusion. The platelet response to the pulmonary allograft, however, has never been studied. Here we report significant platelet activation immediately after lung transplantation.

Methods
We performed a prospective cohort study comparing markers of platelet activation in patients undergoing lung transplantation and patients undergoing nontransplant thoracotomy. Plasma levels of soluble P-selectin, soluble CD40 ligand, and platelet–leukocyte conjugates were measured before surgery, after skin closure, and at 6 postoperative hours.

Results
Both soluble P-selectin and soluble CD40 ligand levels increased significantly after lung transplantation but not after thoracotomy. Additionally, platelet–monocyte conjugate fluorescence was significantly higher after lung transplantation than after thoracotomy alone.

Conclusion
These findings suggest that platelet activation is significantly increased after lung transplantation beyond that expected from the postoperative state. The increase in circulating platelet–monocyte conjugates suggests an important interaction between platelets and inflammatory cells. Further research should examine whether platelet activation affects early graft function after lung transplantation.

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Also Published In

Title
Journal of Thoracic and Cardiovascular Surgery
DOI
https://doi.org/10.1016/j.jtcvs.2007.09.058

More About This Work

Academic Units
Center for Behavioral Cardiovascular Health
Medicine
Surgery
Publisher
Elsevier
Published Here
July 9, 2016
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