Bilateral native lung-sparing lobar transplantation in a canine model

Area of Science:

• Thoracic surgery
• Transplantation immunology
• Pulmonary medicine

Background:

• Cadaveric lung donor shortage necessitates alternative transplantation strategies.
• Living-donor lobar lung transplantation is typically limited to smaller patients due to single-lobe implantation.
• A technique for bilateral lung-sparing lobar transplantation in larger adults is needed.

Purpose of the Study:

• To develop and evaluate a technique for bilateral native lung-sparing lobar transplantation applicable to large adult patients.
• To assess the feasibility and outcomes of this procedure in a preclinical model.

Main Methods:

• Bilateral native lung-sparing lobar transplantation was performed in 12 canine pairs.
• Grafts included the right middle, lower, and cardiac lobes, and the left lower lobe.
• Recipients had native lobes spared, with acute (3-hour) and chronic (3-week) functional and healing assessments.

Main Results:

• Excellent morphologic adaptation of lung grafts was observed.
• Acute study: All 6 animals exhibited excellent pulmonary function.
• Chronic study: 5 of 6 animals survived 3 weeks with excellent pulmonary function and satisfactory bronchial healing.

Conclusions:

• Bilateral native lung-sparing lobar transplantation is technically feasible.
• The procedure demonstrated excellent pulmonary function and good bronchial healing in a canine model.
• This technique holds promise for expanding lung transplantation options for adult patients.