Antegrade versus retrograde perfusion of the donor lung: impact on the early reperfusion phase.
Transpulmonary thermodilution was used to evaluate the effect of flush route during harvest on hemodynamic and respiratory function of the pulmonary graft in the early post-transplant phase. Single lung transplantation was performed in two piglet groups after 24 h of cold storage. Donor organs for group A underwent antegrade perfusion, and those for group R retrograde perfusion. PaO(2), compliance (C), airway resistance (R), extravascular lung water index (EVLWI), pulmonary blood volume index (PBVI), intrathoracic blood volume index (ITBVI), capillary leak (CL), and cardiac function index (CFI) were assessed by transpulmonary thermodilution at baseline, 1, 3, and 6 h after reperfusion. EVLWI was significantly lower in group R. Compliance and PaO(2) were higher in the same group. The two groups did not differ significantly with regard to CFI, PBVI, ITBVI, and airway resistance. Retrograde perfusion of the donor lung had a positive impact on graft function during early reperfusion. Transpulmonary hemodynamic monitoring can be a powerful tool for intra- and postoperative management of transplant patients.
Kofidis
Theo
T
Department of Thoracic and Cardiovascular Surgery, Hanover Medical School, Hanover, Germany. tkofidis@stanford.edu
Strüber
Martin
M
Warnecke
Gregor
G
Sommer
Sebastian
S
Leyh
Rainer G
RG
Balsam
Leora B
LB
Robbins
Robert C
RC
Haverich
Axel
A
D000818:Animals; D015633:Extravascular Lung Water / Q000378:metabolism; D006321:Heart / Q000503:physiopathology; D006439:Hemodynamics; D008168:Lung / Q000503:physiopathology*; D008170:Lung Compliance; D016040:Lung Transplantation; D016343:Monitoring, Intraoperative; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D010477:Perfusion / Q000379:methods*; D011184:Postoperative Period; D011652:Pulmonary Circulation; D015424:Reperfusion; D012129:Respiratory Function Tests; D012137:Respiratory System / Q000503:physiopathology; D013552:Swine; D013815:Thermodilution; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods
D010100:Oxygen