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Acute physiologic changes after extended pulmonary preservation
R S Bonser1, L S Fragomeni, K Harris
1London Chest Hospital, U.K.
The Journal of Heart Transplantation
|May 1, 1990
Summary
This study assessed lung preservation effects in dogs, finding that while gas exchange initially worsened, it remained compatible with survival. The double-lung model offers advantages for studying early preservation impacts.
Area of Science:
- Transplantation immunology
- Cardiothoracic surgery
- Physiology
Background:
- Assessing the physiological impact of extended lung preservation is crucial for improving transplant outcomes.
- Current heart-lung preservation models have limitations in evaluating isolated lung preservation effects.
Purpose of the Study:
- To evaluate the physiological consequences of a 12-hour lung preservation period in a canine double-lung allograft model.
- To determine the feasibility and early effects of this preservation technique.
Main Methods:
- Six mongrel dogs underwent double-lung allotransplantation after 12-hour preservation.
- Donor and recipient animals received specific pharmacological pretreatments (allopurinol, methylprednisolone, deferoxamine).
- Physiological parameters including gas exchange, hemodynamics, and lung mechanics were monitored for 20 hours post-implantation.
Main Results:
- All implantations were technically successful, with two animals succumbing to cardiac standstill.
- Gas exchange showed initial deterioration but remained within survival ranges (PaO2 at 20 hours: 138 +/- 91 mm Hg on FiO2 0.4).
- Pulmonary vascular resistance increased, cardiac output decreased, airway resistance rose, and compliance fell, indicating lung function compromise.
Conclusions:
- The double-lung allograft model provides a valuable platform for assessing early lung preservation effects.
- The employed preservation technique, while causing physiological changes, warrants further investigation for potential clinical application.