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The Annals of Thoracic Surgery, Vol 55, 1185-1191, Copyright © 1993 by The Society of Thoracic Surgeons
KS Ulicny Jr, TM Egan, CJ Lambert Jr, RL Reddick and BR Wilcox
The pulmonary donor pool would increase substantially if lungs could be
safely transplanted after cessation of circulation. To determine whether
ventilation of cadaver lungs could improve graft function, canine donors
were sacrificed and then ventilated with 100% oxygen (n = 6) or 100%
nitrogen (n = 6); 6 served as nonventilated controls. Four hours after
death, the lungs were flushed with modified Euro-Collins solution and
harvested. Controls were ventilated with 100% oxygen only during flush and
harvest. Recipients were rendered dependent on the transplanted lung by
occlusion of the right pulmonary artery and bronchus 1 hour after
transplantation. Ventilation was maintained at a constant inspired oxygen
fraction of 0.4. Four controls died of pulmonary edema shortly after
occlusion of the native lung. The mean arterial oxygen tensions in the
oxygen-ventilated, nitrogen-ventilated, and control groups at the end of 8
hours were 81 mm Hg (n = 4), 88 mm Hg (n = 3), and 55 mm Hg (n = 2),
respectively. Postmortem oxygen ventilation improved early recipient
survival and gas exchange. Postmortem nitrogen ventilation improved early
gas exchange and delayed recipient death compared with non-ventilated
controls. The mechanics of ventilation appears to confer a functional
advantage independent of a continued supply of oxygen. Transplantation of
lungs harvested from cadavers after cessation of circulation might be
feasible.
ARTICLES
Cadaver lung donors: effect of preharvest ventilation on graft function
Department of Surgery, University of North Carolina School of Medicine, Chapel Hill 27599-7065.
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