Partial liquid ventilation with perfluorodecalin following unilateral canine lung allotransplantation in non-heart-beating donors.
BACKGROUND
The purpose of this study was to evaluate canine lungs obtained from non-heart-beating donors after unilateral lung transplantation subjected to partial liquid ventilation with perfluorodecalin.


METHODS
Twelve donor dogs were killed and kept under mechanical ventilation for 3 hours. Heart-lung blocks were harvested after retrograde pulmonary hypothermic flush with Perfadex. Left lung grafts were randomly transplanted into 12 weight-matched recipient animals. Animals were divided into 2 groups: control (standard mechanical ventilation, n = 6) and PLV (partial liquid ventilation, n = 6). Forty-five minutes after transplantation, the animals in the PLV group received perfluorodecalin (15 ml/kg) via orotracheal tube. All animals received volume-controlled ventilation (FIO2) 1.0, PEEP 5 cm H(2)O) over 6 consecutive hours. Thereafter, blood-gas analysis, ventilatory mechanics and hemodynamics were registered at 30-minute intervals. After 6 hours of reperfusion the animals were killed and the transplanted lungs were extracted to obtain the wet/dry weight ratio.


RESULTS
There were significant differences in pulmonary arterial pressure, which were higher in control group animals (p < 0.009). The control animals also showed higher arterial PaO(2) than those in the PLV group (p < 0.00001), but lower PaCO(2) (p < 0.008). The peak and plateau pressures were higher in the PLV group (p < 0.00001). Neither static compliance nor wet/dry weight ratios were different in between groups.


CONCLUSIONS
PLV with perfluorodecalin yields functional results compatible with life in this model. Nonetheless, pulmonary gas exchange and mechanics were superior after reperfusion in animals given conventional mechanical ventilation up to 6 hours after left lung allotransplantation.
Andrade
Cristiano Feijó
CF
Department of Pediatric Thoracic Surgery, Santo Antônio Children's Hospital, Santa Casa de Porto Alegre, Porto Alegre, Brazil.
Martins
Lucas Krieger
LK
Tonietto
Tiago Antônio
TA
Koefender
Cristiano
C
Anflor
Luis Carlos
LC
da Silva
Nilton Brandão
NB
Felicetti
José Carlos
JC
Camargo
José de Jesus Peixoto
Jde J
Fortis
Elaine Aparecida Felix
EA
Cardoso
Paulo Francisco Guerreiro
PF
D000818:Animals; D001802:Blood Substitutes; D016022:Case-Control Studies; D004285:Dogs; D005466:Fluorocarbons; D021061:Liquid Ventilation / Q000379:methods; D016040:Lung Transplantation / Q000502:physiology; D011659:Pulmonary Gas Exchange; D012121:Respiration, Artificial; D015656:Respiratory Mechanics; D014019:Tissue Donors; D014184:Transplantation, Homologous
D001802:Blood Substitutes; D005466:Fluorocarbons; C008805:perfluorodecalin