Lung preservation with low-potassium dextran flush in a primate bilateral transplant model.
We used a bilateral lung transplant model to confirm, in primates, the results of lung preservation studies previously obtained in a canine single-lung transplant model. The donor lungs were flushed with low-potassium dextran solution and maintained semiinflated with 100% oxygen at 10 degrees C for a planned ischemic time of 12 hours for the lung implanted first. Of eight experiments performed, results in the 6 operative survivors form the basis of this report. After bilateral lung transplantation, animals were maintained on a ventilator for 6 hours; arterial oxygen tension, pulmonary artery pressure, and pulmonary vascular resistance were determined in the recipients at 2, 4, and 6 hours after transplantation and compared with donor values, which served as controls. Arterial oxygen tension in the recipients did not differ from the controls (p = not significant), whereas the pulmonary artery pressure and pulmonary vascular resistance showed significant elevation (p < 0.05 versus control values). After the 6 hours of assessment, the animals were extubated and 3 survived for 48 to 72 hours with a mean arterial oxygen tension of 69 mm Hg on room air. These results demonstrate excellent lung function after a minimum of 12 hours of preservation in a primate model in which the animal is totally dependent on the function of transplanted lung tissue, and confirm the potential for prolonged clinical lung preservation.
Sundaresan
S
S
Department of Surgery, Washington University School of Medicine, Barnes Hospital, St. Louis, Missouri 63110.
Lima
O
O
Date
H
H
Matsumura
A
A
Tsuji
H
H
Obo
H
H
Aoe
M
M
Mizuta
T
T
Cooper
J D
JD
D000818:Animals; D001794:Blood Pressure; D002303:Cardiac Output, Low; D002315:Cardiopulmonary Bypass / Q000401:mortality; D002316:Cardiotonic Agents / Q000627:therapeutic use; D003911:Dextrans / Q000008:administration & dosage*; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D016040:Lung Transplantation / Q000379:methods* / Q000401:mortality; D008297:Male; D008954:Models, Biological; D009926:Organ Preservation / Q000379:methods*; D010215:Papio; D011182:Postoperative Care; D011651:Pulmonary Artery / Q000502:physiology; D011659:Pulmonary Gas Exchange; D011859:Radiography; D012996:Solutions; D015996:Survival Rate; D013997:Time Factors; D014655:Vascular Resistance
D002316:Cardiotonic Agents; D003911:Dextrans; D012996:Solutions