A canine experimental study to assess the potential of unilateral double lobar lung transplantation.
OBJECTIVE
We recently reported a technique of unilateral double lobar lung transplantation (UDLLT) in a canine model that was associated with satisfactory early pulmonary function. The purpose of the present experimental study was to assess the quality of bronchial healing, complication rates, survival rates and long-term pulmonary function of this new transplantation technique.


METHODS
Unilateral double lobar lung transplantation was performed in 14 weight-matched pairs of dogs. In recipient animals, two grafts obtained from donor animals were implanted in the right hemithorax after right pneumonectomy. One graft (left graft) was implanted as a right upper lobe in an upside-down position and the other (right graft) was implanted in the natural anatomic position. The immunosuppressed recipients were observed for 3 weeks. Transplanted graft function was assessed under left main pulmonary artery occlusion at 1 and 3 weeks after transplantation.


RESULTS
All animals survived the operation. Pulmonary artery kinking (3/14, 21%) and pulmonary venous thrombus (4/14, 29%) were exclusively observed in the graft implanted in the upside-down position. These complications decreased as the number of transplantations increased. Two of the first seven (29%) and five of the last seven recipient dogs (71%) survived for 3 weeks with excellent pulmonary function and good bronchial healing.


CONCLUSIONS
This procedure was associated with a high complication incidence in the non-anatomically positioned graft. However, a precise surgical technique could decrease these complications. This technically demanding procedure provided excellent pulmonary function and good bronchial healing.
Aokage
Keiju
K
Department of Cancer and Thoracic Surgery, Okayama University Graduate School of Medicine and Dentistry, 2-5-1 Shikata Cho, Okayama City 700-8558, Japan.
Date
Hiroshi
H
Sugimoto
Ryujiro
R
Okazaki
Mikio
M
Okutani
Daisuke
D
Inokawa
Hidetoshi
H
Aoe
Motoi
M
Shimizu
Nobuyoshi
N
D000818:Animals; D001980:Bronchi / Q000503:physiopathology; D002908:Chronic Disease; D004285:Dogs; D008168:Lung / Q000503:physiopathology; D008171:Lung Diseases / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016040:Lung Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D023421:Models, Animal; D011651:Pulmonary Artery / Q000473:pathology; D011667:Pulmonary Veins / Q000473:pathology; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology