Autologous blood pleurodesis in rats to elucidate the amounts of blood required for reliable and reproducible results.
BACKGROUND
Pleurodesis is used in the treatment of spontaneous pneumothorax or refractory pleural effusions of different etiologies. Several agents have been employed, but many questions remain unanswered about their effectiveness and toxicity. Use of autologous blood pleurodesis in clinical practice has been described in the literature without any clear consensus regarding its efficacy. Experimental studies using this technique are limited to a single study in rabbits. We performed a prospective, randomized, observer-blinded, controlled study to evaluate the safety and efficacy of increasing doses of autologous blood pleurodesis in a novel rat model.


METHODS
Twenty-eight albino Wistar rats were divided into four groups. Groups 1, 2, and 3 were the study groups and group 4 was the control group, with seven animals in each group. Groups 1, 2, and 3 were given autologous blood, 1 mL/kg, 2 mL/kg, 3 mL/kg, respectively, and group 4 (control) was given only 2 mL/kg saline intrapleurally. The rats were sacrificed on postoperative day 30. The surfaces were graded by macroscopic (visible adhesion formation) and microscopic (inflammation and fibrosis) examination.


RESULTS
Macroscopically, group 2 and group 3 developed significantly more adhesions; 3 mL/kg autologous blood produced the most significant pleurodesis with generalized adhesions seen between visceral, parietal, and mediastinal pleura. Microscopic examination showed that all study groups developed an inflammatory response at the site of blood injection. There were no pathologic changes in ipsilateral and contralateral lung parenchyma.


CONCLUSIONS
Autologous blood at doses 2-3 mL/kg were shown to be effective to produce adhesions in 30 d, and the results were highly reproducible in all rats. We propose that the occasional negative results obtained in humans may be related to an insufficient amount of injected blood, as observed in our rat model.
Ozpolat
Berkant
B
Department of Thoracic Surgery, Kirikkale University, School of Medicine, Kirikkale, Turkey. berkantozpolat@yahoo.com
Gazyagci
Serkal
S
Gözübüyük
Alper
A
Ayva
Sebnem
S
Atinkaya
Cansel
C
D000199:Actins / Q000378:metabolism; D000818:Animals; D001485:Basement Membrane / Q000473:pathology / Q000637:transplantation; D002404:Catheterization / Q000379:methods; D003094:Collagen / Q000378:metabolism; D015653:Cystectomy / Q000379:methods*; D004285:Dogs; D004847:Epithelial Cells / Q000502:physiology; D005109:Extracellular Matrix / Q000502:physiology; D005260:Female; D007413:Intestinal Mucosa / Q000637:transplantation; D008565:Membrane Proteins / Q000378:metabolism; D051379:Mice; D023421:Models, Animal; D018700:Pleurodesis / Q000379:methods*; D011817:Rabbits; D051381:Rats; D013552:Swine; D054457:Tissue Scaffolds; D014183:Transplantation, Heterologous; D001743:Urinary Bladder / Q000473:pathology / Q000601:surgery*; D060170:Uroplakin II
D000199:Actins; D008565:Membrane Proteins; C554658:UPK2 protein, human; C554659:Upk2 protein, mouse; D060170:Uroplakin II; D003094:Collagen