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[Heart-lung preservation: historical evolution and current research data].
Y M Legal1, R Barthelemy, P Puel
1Department of Surgery, Faculty of Medicine, Memorial University of Newfoundland, St John's, Canada.
Annales De Chirurgie
|January 1, 1991
Summary
Heart-lung transplantation is a viable treatment for end-stage cardiopulmonary disease. Donor organ preservation techniques, including core-cooling and antioxidant therapies, are crucial for successful transplantation outcomes.
Area of Science:
- Cardiovascular Surgery
- Transplantation Immunology
- Organ Preservation
Context:
- Heart-lung transplantation is an established therapy for end-stage cardiopulmonary disease.
- Limited donor availability and organ procurement challenges hinder widespread practice.
- Current preservation methods have limitations in efficacy and complexity.
Purpose:
- To review and evaluate established and novel techniques for heart-lung organ preservation.
- To explore strategies for mitigating ischemia-reperfusion injury in heart-lung transplantation.
- To identify optimal methods for distant organ procurement and preservation.
Summary:
- Normothermic autoperfusion and single cold flush perfusion with prostaglandin E1 are discussed preservation methods.
- Donor core-cooling via cardiopulmonary bypass without pulmonary artery flush shows promise for improved graft protection.
- Oxygen radical production during reperfusion is a key concern; enzymatic scavengers and iron chelators may reduce injury.
Impact:
- Improved organ preservation techniques can enhance heart-lung transplant success rates.
- Minimizing ischemia-reperfusion injury is critical for long-term graft function and patient survival.
- Advancements in procurement and preservation may expand the applicability of heart-lung transplantation.