Unilateral lung transplantation using right and left upper lobes: an experimental study.
OBJECTIVE
The shortage of organ donors is a serious problem in Japan. The right and left upper lobes of rejected extended-criteria lungs have the potential to be used for downsized lung transplantation; however, the 2 upper lobes are too small for a size-matched recipient. The present study investigated the feasibility of unilateral transplantation using the right and left upper lobes.


METHODS
After harvesting the heart-lung block from donor swine, a left lung graft was created using the right and left upper lobes and transplanted into the left thoracic space of the recipient swine (group A, n = 5). We then evaluated graft function for 6 hours and compared these results with those of a control group (group B, n = 5), in which orthotopic left lung transplantation had been performed.


RESULTS
The mean partial pressure of oxygen in the arterial blood gas after reperfusion was 507 mm Hg in group A and 463 mm Hg in group B (P = .2). The mean pulmonary arterial pressure was 30.3 mm Hg in group A and 27.5 mm Hg in group B (P = .4). The mean airway pressure was 6.4 mm Hg in group A and 6.2 mm Hg in group B (P = .7).


CONCLUSIONS
Our results suggest that unilateral left lung transplantation using the right and left upper lobes is technically and functionally feasible for size-matched recipients. In addition, this technique enables the use of rejected lungs if the upper lobes are still intact.
Department of General Thoracic Surgery, Okayama University Graduate School of Medicine, Okayama, Japan.
Hitoshi
H
Nishikawa
Takahiro
T
Oto
Shinji
S
Otani
Masaaki
M
Harada
Norichika
N
Iga
Kentaroh
K
Miyoshi
Shinichiro
S
Miyoshi
D000818:Animals; D062186:Arterial Pressure; D005240:Feasibility Studies; D008168:Lung / Q000098:blood supply* / Q000503:physiopathology / Q000601:surgery*; D016040:Lung Transplantation / Q000379:methods*; D023421:Models, Animal; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D011013:Pneumonectomy; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D011859:Radiography; D013552:Swine; D013997:Time Factors; D014654:Vascular Patency
D010100:Oxygen
12; AWP; PA; PAP; PV; airway pressure; pulmonary arterial pressure; pulmonary artery; pulmonary vein