Optimal time for post-mortem heparinization in canine lung transplantation with non-heart-beating donors.
BACKGROUND
We previously reported that post-mortem heparinization by closed-chest cardiac massage is beneficial in lung transplantation from non-heart-beating donors by preventing formation of microthrombi. In this study, we evaluated the optimal time for post-mortem heparinization in canine lung transplantation from non-heart-beating donors.


METHODS
Left lung transplantation was performed in 25 weight-matched pairs of mongrel dogs. Donors were killed with an intravenous injection of potassium chloride and left at room temperature for 2 hours. The cadaver donors were assigned randomly to one of five study groups. In Group H0, heparin sodium (1,000 U/kg) was given intravenously before cardiac arrest. In Groups H10, H30, H45 and H60, heparin sodium (1,000 U/kg) was given intravenously 10, 30, 45 and 60 minutes after cardiac arrest, respectively, followed by closed-chest cardiac massage for 2 minutes. After 2 hours of cardiac arrest, donor lungs were flushed with low-potassium dextran glucose solution and preserved for 60 minutes. After left lung allotransplantation, the right pulmonary artery was ligated, and recipient animals were followed up for 3 hours. Uni- and multivariate repeat analyses were utilized for statistical assessment.


RESULTS
After transplantation, gas exchange was significantly worse in Groups H45 and H60 than in Groups H0, H10 and H30. Thrombin/anti-thrombin III complex concentration during warm ischemia was significantly higher in Groups H30, H45 and H60 than in Groups H0 and H10.


CONCLUSIONS
The optimal time for post-mortem heparinization in lung transplantation from non-heart-beating donors is approximately 30 minutes after cardiac arrest.
Department of Cancer and Thoracic Surgery (Surgery II), Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.
Mikio
M
Okazaki
Hiroshi
H
Date
Hidetoshi
H
Inokawa
Daisuke
D
Okutani
Keiju
K
Aokage
Itaru
I
Nagahiro
Motoi
M
Aoe
Yoshifumi
Y
Sano
Nobuyoshi
N
Shimizu
D000818:Animals; D000925:Anticoagulants / Q000627:therapeutic use*; D004285:Dogs; D006324:Heart Arrest, Induced / Q000009:adverse effects; D006493:Heparin / Q000627:therapeutic use*; D016040:Lung Transplantation; D009926:Organ Preservation / Q000379:methods*; D012129:Respiratory Function Tests; D013927:Thrombosis / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D013997:Time Factors; D014019:Tissue Donors
D000925:Anticoagulants; D006493:Heparin