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Ann Thorac Surg 1991;52:1113-1121
© 1991 The Society of Thoracic Surgeons

Articles

A strategy to increase the donor pool: Use of cadaver lungs for transplantation

Thomas M. Egan, MD*, C.Jake Lambert, Jr, MD, Robert Reddick, MD, Karl S. Ulicny, Jr, MD, Blair A. Keagy, MD, Benson R. Wilcox, MD

Division of Cardiothoracic Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina USA

* Address reprint requests to Dr Egan, University of North Carolina, CB 7065, 108 Burnett-Womack Building, Chapel Hill, NC 27599-7065.

A shortage of suitable donors is a serious obstacle to the widespread application of isolated lung transplantation for end-stage lung disease. We hypothesized that lung tissue likely remains viable for a sufficient period of time to allow for safe postmortem retrieval of lungs for transplantation. Studies were conducted in a nonsurvival model of canine lung allotransplantation. Donor animals were sacrificed, and subsequent lung harvest was delayed for 1 hour, 2 hours, or 4 hours. Pulmonary retrieval was then performed in a standard fashion, flushing the lung block with modified Euro-Collins solution. Lungs were then stored for 4 hours before single allotransplantation. Recipient animals were maintained anesthetized, and followed up for 8 hours. By occlusion of the pulmonary artery and bronchus to the native lung, recipient animals were forced to survive solely on the transplanted lung, with a constant inspired oxygen fraction of 0.40. All 5 recipient animals of 1-hour cadaver lungs survived the 8-hour observation period with excellent hemodynamics and gas exchange. Two of 5 recipients of 2-hour cadaver lungs survived the observation period, whereas a third animal survived for 5 hours with excellent gas exchange. One of 4 animals transplanted with a 4-hour cadaver lung survived the observation period. Retrieval of lungs from cadavers whose hearts are not beating may prove to be a safe and effective method to increase the pulmonary donor pool.




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