Ex vivo application of carbon monoxide in University of Wisconsin solution to prevent intestinal cold ischemia/reperfusion injury

Am J Transplant. 2006 Oct;6(10):2243-55. doi: 10.1111/j.1600-6143.2006.01465.x. Epub 2006 Jul 6.

Abstract

Carbon monoxide (CO), a byproduct of heme catalysis, was shown to have potent cytoprotective and anti-inflammatory effects. In vivo recipient CO inhalation at low concentrations prevented ischemia/reperfusion (I/R) injury associated with small intestinal transplantation (SITx). This study examined whether ex vivo delivery of CO in University of Wisconsin (UW) solution could ameliorate intestinal I/R injury. Orthotopic syngenic SITx was performed in Lewis rats after 6 h cold preservation in control UW or UW that was bubbled with CO gas (0.1-5%) (CO-UW). Recipient survival with intestinal grafts preserved in 5%, but not 0.1%, CO-UW improved to 86.7% (13/15) from 53% (9/17) with control UW. At 3 h after SITx, grafts stored in 5% CO-UW showed improved intestinal barrier function, less mucosal denudation and reduced inflammatory mediator upregulation compared to those in control UW. Preservation in CO-UW associated with reduced vascular resistance (end preservation), increased graft cyclic guanosine monophosphate levels (1 h), and improved graft blood flow (1 h). Protective effects of CO-UW were reversed by ODQ, an inhibitor of soluble guanylyl cyclase. In vitro culture experiment also showed better preservation of vascular endothelial cells with CO-UW. The study suggests that ex vivo CO delivery into UW solution would be a simple and innovative therapeutic strategy to prevent transplant-induced I/R injury.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenosine / chemistry
  • Adenosine / pharmacokinetics
  • Adenosine / pharmacology
  • Allopurinol / chemistry
  • Allopurinol / pharmacokinetics
  • Allopurinol / pharmacology
  • Animals
  • Antimetabolites / analysis
  • Antimetabolites / pharmacokinetics
  • Antimetabolites / pharmacology*
  • Carbon Monoxide / analysis
  • Carbon Monoxide / pharmacokinetics
  • Carbon Monoxide / pharmacology*
  • Disease Models, Animal
  • Glutathione / chemistry
  • Glutathione / pharmacokinetics
  • Glutathione / pharmacology
  • Graft Survival / drug effects
  • Insulin / chemistry
  • Insulin / pharmacokinetics
  • Insulin / pharmacology
  • Intestinal Mucosa / drug effects
  • Intestinal Mucosa / metabolism
  • Intestinal Mucosa / ultrastructure
  • Intestine, Small / blood supply*
  • Intestine, Small / metabolism
  • Intestine, Small / transplantation*
  • Male
  • Microscopy, Electron, Transmission
  • Organ Preservation
  • Organ Preservation Solutions / chemistry
  • Organ Preservation Solutions / pharmacokinetics
  • Organ Preservation Solutions / pharmacology*
  • Organ Transplantation / adverse effects*
  • Raffinose / chemistry
  • Raffinose / pharmacokinetics
  • Raffinose / pharmacology
  • Rats
  • Rats, Inbred Lew
  • Reperfusion Injury / etiology
  • Reperfusion Injury / metabolism
  • Reperfusion Injury / prevention & control*
  • Treatment Outcome

Substances

  • Antimetabolites
  • Insulin
  • Organ Preservation Solutions
  • University of Wisconsin-lactobionate solution
  • Allopurinol
  • Carbon Monoxide
  • Glutathione
  • Adenosine
  • Raffinose