HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Scott Bradley Brian W. Duncan Edward D. Verrier Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Crombleholme, T. M. Articles by Harrison, M. R. Search for Related Content PubMed PubMed Citation Articles by Crombleholme, T. M. Articles by Harrison, M. R.

Ann Thorac Surg 1990;49:55-60
© 1990 The Society of Thoracic Surgeons

---

Articles

Reduced-size lung transplantation in neonatal swine: Technique and short-term physiological response

Fetal Treatment Program and Department of Surgery, University of California, San Francisco, California USA

^_* Address reprint requests to Dr Adzick, Fetal Treatment Program, 585 HSE, University of California, San Francisco, Third and Parnassas Aves, San Francisco, CA 94143.

Lung transplantation is now a clinical reality in adults but is limited by the scarcity of appropriate donors. The donor shortage is even more acute for neonatal and pediatric patients. Reduced-size lung grafts would expand the pool of appropriate cadaveric donors and allow HLA-matched living related lobar or segmental lung transplants. To evaluate this experimentally, we developed a model of pulmonary lobar transplantation in neonatal pigs and studied the acute hemodynamic response after transplanting the left lower lobe from a more mature donor to a neonatal recipient. Technical considerations included using the recipient atrial appendage for the pulmonary venous anastomosis. Nine pairs of pigs underwent left lateral thoracotomy. The recipient left atrial and pulmonary arterial pressures, cardiac output, and pulmonary vascular resistance were measured before pneumonectomy and after left lower lobe transplantation. Although the left atrial and pulmonary arterial pressures remained unchanged after transplantation, there was a 15% increase in pulmonary vascular resistance and a 23% reduction in cardiac output. Neither change was statistically significant. The distribution of blood flow through the left and right pulmonary arteries was unchanged after transplantation. We conclude that lobar transplantation is technically feasible in immature animals and that the pulmonary venous anas tomosis to the left atrial appendage facilitates the procedure. This model may prove useful in studying lung transplantation in immature recipients and expedite implementation of reduced-size lung transplantation in neonatal and pediatric patients.

This article has been cited by other articles:

				M. E. Bowdish, M. L. Barr, and V. A. Starnes Living-donor lobar transplantation Lung Transplantation, July 1, 2010; 257 - 268. [Abstract] [Fulltext] [PDF]

				D. V. Raemdonck, W. Coosemans, W. Klepetko, J. H. Dark, S. Steen, and F. Rega Alternatives to lung donor shortage Surgery for Non-Neoplastic Disorders of the Chest: a Clinical Update, June 28, 2010; 89 - 112. [Abstract] [Fulltext] [PDF]

				D. E. M. Van Raemdonck, G. M. Verleden, W. Coosemans, H. Decaluwe, G. Decker, P. De Leyn, P. Nafteux, and T. Lerut Increasing the donor pool Lung Transplantation, June 7, 2010; 104 - 127. [Abstract] [Fulltext] [PDF]

				I. Matsumoto, M. Oda, Y. Tsunezuka, M. Tamura, K. Kawakami, and G. Watanabe Experimental study of extracorporeal lung resection in dogs: Ex situ sleeve resection and autotransplantation of the pulmonary lobe after extended pneumonectomy for central lung cancer J. Thorac. Cardiovasc. Surg., May 1, 2004; 127(5): 1343 - 1349. [Abstract] [Full Text] [PDF]

				M. G. Massad, C. Sirois, S. Tripathy, H. A. Jaffe, N. Snow, and A. S. Geha Pulmonary venous drainage into the left atrial appendage facilitates transplantation of the left lung with difficult exposure Ann. Thorac. Surg., March 1, 2001; 71(3): 1046 - 1047. [Abstract] [Full Text] [PDF]

				A. A. Hislop, R. R. Lee, C. G. A. McGregor, and S. G. Haworth Lung Growth After Transplantation Of An Adult Lobe Of Lung Into A Juvenile Rat J. Thorac. Cardiovasc. Surg., March 1, 1998; 115(3): 644 - 651. [Abstract] [Full Text] [PDF]

				O. A. R. Binns, N. F. DeLima, S. A. Buchanan, M. B. S. Lopes, J. T. Cope, C. A. Marek, R. C. King, V. E. Laubach, C. G. Tribble, and I. L. Kron MATURE PULMONARY LOBAR TRANSPLANTS GROW IN AN IMMATURE ENVIRONMENT J. Thorac. Cardiovasc. Surg., August 1, 1997; 114(2): 186 - 194. [Abstract] [Full Text]

				J.-P. A. Couetil, M. J. Tolan, D. F. Loulmet, A. Guinvarch, P. G. Chevalier, A. Achkar, P. Birmbaum, and A. F. Carpentier PULMONARY BIPARTITIONING AND LOBAR TRANSPLANTATION: A NEW APPROACH TO DONOR ORGAN SHORTAGE J. Thorac. Cardiovasc. Surg., March 1, 1997; 113(3): 529 - 537. [Abstract] [Full Text]

				V. A. Starnes, M. L. Barr, and R. G. Cohen Lobar transplantation: Indications, technique, and outcome J. Thorac. Cardiovasc. Surg., September 1, 1994; 108(3): 403 - 411. [Abstract] [Full Text]

				J. A. Kern, C. G. Tribble, J. G. Zografakis, D. C. Cassada, B. B. K. Chan, and I. L. Kron Analysis of airway function of immature whole lung transplants versus mature lobar transplants Ann. Thorac. Surg., May 1, 1994; 57(5): 1089 - 1094. [Abstract] [PDF]

				J. A. Kern, C. G. Tribble, B. B. K. Chan, T. L. Flanagan, and I. L. Kron Reduced-size porcine lung transplantation: Long-term studies of pulmonary vascular resistance Ann. Thorac. Surg., April 1, 1992; 53(4): 583 - 589. [Abstract] [PDF]