Lung transplantation from dogs with non beating hearts

effect of cadaver cooling and pulmonary flushing

Abstract

We evaluated the effect of cadaver cooling and pulmonary flushing on lungs transplanted from dogs with non beating hearts. Donors were killed with a KCl injection without hepariniza-tion and the lungs were inflated with 100% O₂. They were divided into the following three groups of 6 dogs each. Group I donors were kept at room temperature for 4 hours (warm ischemic time : WIT). Group II donors were cooled by crushed ice for 4 hours (cold ischemic time : CIT). Group III donors were kept at room temperature for 1 hour, and the lungs were then flushed with low potassium dextran glucose solution and preserved in the same solution for 3 or more hours. After left lung transplantation, the function of the transplanted lung, arterial blood gas analysis and pulmonary hemodynamics were assessed for 6 hours after ligation of the right pulmonary artery of the recipient animals. The lungs in group III had significantly better PaO₂ and PaCO₂ than did those in groups I and II. Pulmonary hemodynamics did not differ among the three groups. The wet/dry ratio of thetransplanted lungs after 6 hours of single lung perfusion was significantly lower in group III than in groups I and II : 4.99 ± 0.23 in group III, 6.20 ± 0.26 in group I and 5.77 ± 0.55 in group II (p <0.05). These results indicated that (1) cadaver cooling with crushed ice dose not provide significant protection for cadaver lungs and (2) for successful lung transplantation from donors with non beating hearts, it is necessary to flush the lungs with an appropriate solution soon (about 1 hour) after cardiac arrest.