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Canine double-lung transplantation with cadaveric donors
C S Roberts1, A M D'Armini, T M Egan
1Department of Surgery, University of North Carolina School of Medicine, Chapel Hill 27599-7065, USA.
The Journal of Thoracic and Cardiovascular Surgery
|September 1, 1996
Summary
Utilizing cadaveric donor lungs retrieved up to 4 hours after death for lung transplantation shows promising results. This approach may help alleviate donor shortages, with reversible ischemia-reperfusion injury observed in canine models.
Area of Science:
- Transplantation immunology
- Cardiovascular and Respiratory Systems
Background:
- Critical shortage of donor lungs for transplantation.
- Potential to alleviate donor scarcity by using cadaveric lungs post-circulatory arrest.
Purpose of the Study:
- To assess gas exchange and recipient outcomes after double-lung transplantation using cadaveric donor lungs.
- To evaluate the feasibility of using lungs retrieved at 2 and 4 hours postmortem.
Main Methods:
- Performed sequential double-lung transplantation in 12 dogs.
- Lungs were harvested 2 or 4 hours after donor sacrifice and flushed with modified Euro-Collins solution.
- Recipients were monitored for 8 hours post-transplantation, with adjustments to inspired oxygen.
Main Results:
- Nine of 12 recipients survived the 8-hour study period.
- Alveolar-arterial oxygen gradient and extravascular lung water increased initially but significantly decreased by 8 hours post-transplantation.
- Recipient outcomes and gas exchange parameters were similar between lungs retrieved at 2 and 4 hours postmortem.
Conclusions:
- Donor lungs retrieved up to 4 hours postmortem can yield similar recipient outcomes.
- Ischemia-reperfusion injury appears reversible within the 8-hour study period.
- This approach holds potential for increasing the number of lung transplant procedures if safely applicable in clinical practice.