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Warm ischemic time tolerance after ventilated non-heart-beating lung donation in piglets
R Greco1, G Cordovilla, E Sanz
1Pediatric Cardiothoracic Surgery, La Paz Children's Hospital, Madrid, Spain. rgreco@surgical.net
Summary
Lung grafts from ventilated non-heart-beating donors (VNHBD) show function equivalent to heart-beating donors, even with up to 90 minutes of warm ischemia time (WIT). This research suggests VNHBD is a promising strategy to expand the lung donor pool.
Area of Science:
- Transplantation immunology
- Cardiovascular surgery
- Pulmonary medicine
Background:
- Lung transplantation is limited by donor organ availability.
- Ventilated non-heart-beating donors (VNHBD) offer a potential source of lungs.
- Determining the maximum tolerable warm ischemia time (WIT) is crucial for VNHBD lung viability.
Purpose of the Study:
- To assess the functional viability of lung grafts from VNHBD.
- To establish the maximum acceptable in situ warm ischemia time (WIT) for VNHBD lung grafts.
Main Methods:
- Left lung allotransplantation was performed in 20 piglets.
- Animals were divided into groups based on donor status: Sham, and VNHBD with WIT of 30, 60, or 90 minutes.
- Pulmonary function was monitored for 6 hours post-reperfusion via hemodynamic, oxygenation, and mechanical measurements.
Main Results:
- Lung grafts from VNHBD were heavier post-transplant compared to controls.
- Hemodynamic and lung mechanics changes were observed after right lung exclusion in all groups.
- No significant functional difference was noted between VNHBD lungs (up to 90 min WIT) and heart-beating donor lungs.
Conclusions:
- Lung grafts from VNHBD with up to 90 minutes of WIT demonstrate post-transplantation function comparable to grafts from heart-beating donors.
- Utilizing VNHBD lungs is a viable strategy to increase the availability of pulmonary organs for transplantation.