Pulmonary function after non-heart-beating lung donation in a survival model.
BACKGROUND
Lung procurement from recently deceased cadavers has been suggested to enlarge the limited donor pool. We hypothesized that lungs harvested from non-heart-beating donors (NHBD) would function as well as those harvested from heart-beating donors.


METHODS
Sixteen adult swine underwent left lung allotransplantation. Controls received lungs procured from heart-beating donors, NHBD pigs received lungs immediately harvested from donors after death from asphyxiation, and NHBD-15 and NHBD-30 pigs received lungs harvested after 15 and 30 minutes after asphyxiation.


RESULTS
After 1 week of survival, mean dynamic airway compliance (mL/cm H2O +/- standard error of the mean) was 16.3 +/- 0.7 in controls, and 17.3 +/- 1.0, 16.4 +/- 6.0, and 7.3 +/- 1.6 in the NHBD, NHBD-15, and NHBD-30 groups, respectively (p = 0.02, NHBD-30 versus others combined). No significant differences were noted in the pulmonary venous partial pressure of oxygen or pulmonary vascular hemodynamics compared with controls.


CONCLUSIONS
The decrease in airway compliance noted in the NHBD-30 group may reflect an exacerbation of reperfusion injury caused by 30 minutes of warm ischemia during organ retrieval. We conclude that posttransplantation lung function using an NHBD with up to 15 minutes of warm ischemia is equivalent to lung function after heart-beating harvest.
Buchanan
S A
SA
Department of Surgery, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
DeLima
N F
NF
Binns
O A
OA
Mauney
M C
MC
Cope
J T
JT
Langenburg
S E
SE
Shockey
K S
KS
Bianchi
J D
JD
Parekh
V I
VI
Tribble
C G
CG
D000818:Animals; D001794:Blood Pressure; D006085:Graft Survival / Q000502:physiology*; D008170:Lung Compliance; D016040:Lung Transplantation / Q000502:physiology*; D011651:Pulmonary Artery / Q000502:physiology; D011659:Pulmonary Gas Exchange; D015656:Respiratory Mechanics; D013552:Swine; D009927:Tissue and Organ Procurement; D014655:Vascular Resistance