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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
PubMed
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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.

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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.