抄録
Lung transplantation is an effective treatment for a variety of end-stage pulmonary diseases. A novel approach to increase the donor pool is to harvest organs from non-heart-beating donors (NHBD) . However, clots or fat emboli may jeopardize the uniformity of the pulmonary arterial (PA) flushing in the NHBD graft. The present study was performed to investigate the effects of retrograde pulmonary flushing through the pulmonary vein (PV) before reperfusion in the NHBD rat lung. The efficacy of heparin is also analyzed. The heart-lung bloc was excised 0 min (groups 1 and 2) or 30 min (groups 3, 4, and 5) after euthanasia. The grafts were flushed through the PA in groups 1 and 3 and were flushed through the PV in groups 2 and 4. In group 5, the grafts were flushed with heparin through the PV. The grafts were then ventilated and reperfused. During reperfusion the PA pressure (PAP) and airway pressure (AWP) were recorded. After reperfusion the wet to dry weight ratio (W/D) of the lung was measured as an estimate of the extent of lung edema. AWP, PAP and W/D were not significantly different between groups 1 and 2. PAP and W/D were higher in group 3 than in group 1 (p<0.05 and p<0.01, respectively) . PAP was not significantly different between groups 2 and 4 and W/D was higher in group 4 than in group 2 (p<0.05) . W/D was lower in group 4 than in group 3 (p<0.05) . PAP was lower in group 5 than in group 3 (p<0.05) and W/D was lower in group 5 than in groups 3 and 4 (p<0.0l and p<0.05, respectively) . In conclusion, PV flushing decreased lung edema when compared with PA flushing and the edema was reduced more effectively in the group with PV flushing with heparin than in the group without heparin in NHBD lung. Without prolonged warm ischemia, the PV flush method did not improve lung edema when compared with the PA flush method.
