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The Journal of Thoracic and Cardiovascular Surgery, Vol 98, 529-534, Copyright © 1989 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
SH Keshavjee, F Yamazaki, PF Cardoso, DI McRitchie, GA Patterson and JD Cooper
The clinical application of lung transplantation is severely limited by the
shortage of suitable donor organs. Current techniques of lung preservation
allow a maximum of 4 to 6 hours of safe ischemic time. The function of
canine left lung allografts stored for 12 hours after being cooled by
pulmonary artery flush was studied. Two types of flush solution were used:
group I; Euro-Collins solution; group II, low- potassium-dextran solution.
Lung function was studied immediately and 3 days after transplantation.
This protocol enables study of acute preservation-related lung injury and
the delayed manifestations of ischemic and reperfusion injury after a 3-day
period of recovery. Inflatable cuffs were placed around each pulmonary
artery at operation and were attached to subcutaneous injection ports.
Temporarily occluding either pulmonary artery allowed independent study of
the native or transplanted lung. Using this model, we were able to
demonstrate reliable and reproducible preservation of lungs for 12 hours.
The low-potassium-dextran solution provided significantly better immediate
function of the preserved lung than the Euro-Collins solution: arterial
oxygen tension 509 +/- 15 mm Hg versus 111 +/- 16 mm Hg (p less than
0.0001). Function on the third day was excellent for both groups. Pulmonary
artery pressure, pulmonary vascular resistance, and carbon dioxide tension
were not significantly different between the groups immediately or on day
3.
ARTICLES
A method for safe twelve-hour pulmonary preservation
Department of Surgery, University of Toronto, Ontario, Canada.
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