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Related Experiment Videos

Unilateral donor lung dysfunction does not preclude successful contralateral single lung transplantation.

J D Puskas1, T L Winton, J D Miller

  • 1Department of Surgery, University of Toronto, Toronto General Hospital, Ontario, Canada.

The Journal of Thoracic and Cardiovascular Surgery
|May 1, 1992
PubMed
Summary

Assessing unilateral lung function in potential donors with contralateral disease can identify suitable single lung grafts. This method helps overcome donor lung shortages by evaluating individual lung viability, increasing transplant availability.

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Area of Science:

  • Thoracic Surgery
  • Transplantation Medicine
  • Pulmonary Medicine

Background:

  • Single lung transplantation is hindered by a scarcity of suitable donor lungs.
  • Current donor criteria may exclude viable lungs due to unilateral disease or injury.
  • Contralateral lung issues can lead to the discard of otherwise adequate single lung grafts.

Purpose of the Study:

  • To evaluate the utility of intraoperative unilateral ventilation and perfusion for assessing single lung function in potential donors.
  • To determine if this method can increase the pool of available single lung grafts.
  • To assess the outcomes of single lung transplants utilizing grafts identified through this technique.

Main Methods:

  • Implemented intraoperative unilateral ventilation and perfusion in potential lung donors with contralateral lung disease.

Related Experiment Videos

  • Utilized a double-lumen endotracheal tube or endobronchial balloon occlusion catheter to isolate ventilation to the uninjured lung.
  • Clamped the pulmonary artery to the injured lung and measured arterial oxygen tension (PaO2) with inspired oxygen fraction (FiO2) of 1.0 and positive end-expiratory pressure (PEEP) of 5 cm H2O.

    • Main Results:

    • Four out of 18 single lung transplants (22%) involved donors with significant unilateral lung injury.
    • Initial donor PaO2 levels were below accepted criteria (246 +/- 47 mm Hg).
    • Post-unilateral assessment, PaO2 significantly improved (499.5 +/- 43 mm Hg; p < 0.0004), indicating excellent unilateral lung function.

    Conclusions:

    • Assessment of unilateral lung function in selected potential donors is feasible and beneficial.
    • This technique can significantly expand the availability of single lung grafts.
    • Transplantation of these identified single lungs resulted in adequate early post-operative function in recipients.