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      Emerging trends and hotspots in animal experimental research on lung transplantation from 2004 to 2023: a bibliometric analysis

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          Abstract

          Background

          Lung transplantation is the only viable option for end-stage respiratory diseases, with the global prevalence of this procedure on the rise in recent years. However, it is still plagued by various complications, for which no satisfactory therapy has yet been identified. Understanding the mechanisms underlying these post-transplant complications may be beneficial to enhance patient outcomes. This study utilized bibliometric analysis to assess present publication trends and focal points in the field of animal experimental studies on lung transplantation, aiming to provide insights into potential areas for future research.

          Methods

          Utilizing CiteSpace software, the Online Analysis Platform of Literature Metrology, R package bibliometrix and VOSviewer, an analysis of current publication trends and hotspots in the area of animal experimental research for lung transplantation was carried out for the period spanning from 2004 to 2023. The English articles were searched in the Science Citation Index-Expanded (SCI-E) of Web of Science Core Collection (WoSCC).

          Results

          A total of 995 articles on animal experimental research on lung transplantation over the past two decades were retrieved. Rats, mice and swine were the most commonly used animal models, with orthotopic lung transplantation, ischemia-reperfusion (IR), and ex vivo lung perfusion (EVLP) being the most frequently employed model of lung transplantation in animals. The leading contributed countries in this area were USA, Canada, Japan and China. Washington University and Shaf Keshavjee were acknowledged as the most influential institute and scholar, respectively. The top 10 main clusters identified through co-occurrence cluster analysis included, ex-vivo lung perfusion, EVLP, obliterative bronchiolitis, necroptosis, bronchiolitis obliterans, non-heart-beating donor, donation after circulatory death, xenotransplantation, hydrogen sulfide and alveolar macrophage. Current research focused on lung IR injury, lung transplant, hypoxia, and differentiation, as revealed by keyword burst detection.

          Conclusions

          Over the past 20 years, global publications on animal experimental research for lung transplantation have grown rapidly. The current research hotspots focus on lung IR injury, hypoxia and differentiation during lung transplantation. Exploring the potential synergistic effects of EVLP and necroptosis inhibition in more depth could offer valuable information for improving lung transplant outcomes. Our analysis presents a detailed overview of the current state of animal experimental research in lung transplantation, evaluating current publication trends and focal points and providing significant insights for future research efforts.

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          Most cited references55

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          Normothermic ex vivo lung perfusion in clinical lung transplantation.

          More than 80% of donor lungs are potentially injured and therefore not considered suitable for transplantation. With the use of normothermic ex vivo lung perfusion (EVLP), the retrieved donor lung can be perfused in an ex vivo circuit, providing an opportunity to reassess its function before transplantation. In this study, we examined the feasibility of transplanting high-risk donor lungs that have undergone EVLP. In this prospective, nonrandomized clinical trial, we subjected lungs considered to be high risk for transplantation to 4 hours of EVLP. High-risk donor lungs were defined by specific criteria, including pulmonary edema and a ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen (PO(2):FIO(2)) less than 300 mm Hg. Lungs with acceptable function were subsequently transplanted. Lungs that were transplanted without EVLP during the same period were used as controls. The primary end point was primary graft dysfunction 72 hours after transplantation. Secondary end points were 30-day mortality, bronchial complications, duration of mechanical ventilation, and length of stay in the intensive care unit and hospital. During the study period, 136 lungs were transplanted. Lungs from 23 donors met the inclusion criteria for EVLP; in 20 of these lungs, physiological function remained stable during EVLP and the median PO(2):FIO(2) ratio increased from 335 mm Hg in the donor lung to 414 and 443 mm Hg at 1 hour and 4 hours of perfusion, respectively (P<0.001). These 20 lungs were transplanted; the other 116 lungs constituted the control group. The incidence of primary graft dysfunction 72 hours after transplantation was 15% in the EVLP group and 30% in the control group (P=0.11). No significant differences were observed for any secondary end points, and no severe adverse events were directly attributable to EVLP. Transplantation of high-risk donor lungs that were physiologically stable during 4 hours of ex vivo perfusion led to results similar to those obtained with conventionally selected lungs. (Funded by Vitrolife; ClinicalTrials.gov number, NCT01190059.).
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            Chronic lung allograft dysfunction: Definition, diagnostic criteria, and approaches to treatment―A consensus report from the Pulmonary Council of the ISHLT

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              Regeneration and orthotopic transplantation of a bioartificial lung.

              About 2,000 patients now await a donor lung in the United States. Worldwide, 50 million individuals are living with end-stage lung disease. Creation of a bioartificial lung requires engineering of viable lung architecture enabling ventilation, perfusion and gas exchange. We decellularized lungs by detergent perfusion and yielded scaffolds with acellular vasculature, airways and alveoli. To regenerate gas exchange tissue, we seeded scaffolds with epithelial and endothelial cells. To establish function, we perfused and ventilated cell-seeded constructs in a bioreactor simulating the physiologic environment of developing lung. By day 5, constructs could be perfused with blood and ventilated using physiologic pressures, and they generated gas exchange comparable to that of isolated native lungs. To show in vivo function, we transplanted regenerated lungs into orthotopic position. After transplantation, constructs were perfused by the recipient's circulation and ventilated by means of the recipient's airway and respiratory muscles, and they provided gas exchange in vivo for up to 6 h after extubation.
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                Author and article information

                Journal
                J Thorac Dis
                J Thorac Dis
                JTD
                Journal of Thoracic Disease
                AME Publishing Company
                2072-1439
                2077-6624
                27 February 2025
                28 February 2025
                : 17
                : 2
                : 796-815
                Affiliations
                [1 ]deptDepartment of Anesthesiology , The Second Affiliated Hospital of Zhejiang University School of Medicine , Hangzhou, China;
                [2 ]deptDepartment of Anesthesiology , The First Affiliated Hospital of Huzhou University , Huzhou, China
                Author notes

                Contributions: (I) Conception and design: C Xie, M Yan; (II) Administrative support: Y Yao, B Jiang, X Wang, M Yan; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: C Xie, X Tao, M Piao; (V) Data analysis and interpretation: C Xie, X Tao, L Zhou; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

                Correspondence to: Min Yan, PhD. Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou 310009, China. Email: zryanmin@ 123456zju.edu.cn .
                Article
                jtd-17-02-796
                10.21037/jtd-24-1451
                11898359
                40083532
                a48550a5-c5ed-424f-8966-c17cb925ebb9
                Copyright © 2025 AME Publishing Company. All rights reserved.

                Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0.

                History
                : 01 September 2024
                : 27 December 2024
                Funding
                Funded by: the National Clinical Key Specialty Construction Project of China 2021
                Award ID: No. 2021-LCZDZK-01
                Categories
                Original Article

                lung transplantation,animal model,bibliometric analysis,citespace,hotspots

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