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Sudhir Sundaresan
Oriane Lima
Hiroshi Date
Akihide Matsumura
Hidefumi Obo
Motoi Aoe
Joel D. Cooper
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Ann Thorac Surg 1993;56:1129-1135
© 1993 The Society of Thoracic Surgeons


Articles

Lung preservation with low-potassium dextran flush in a primate bilateral transplant model

Sudhir Sundaresan, MD*, Oriane Lima, MD, Hiroshi Date, MD, Akihide Matsumura, MD, Hiroharu Tsuji, MD, Hidefumi Obo, MD, Motoi Aoe, MD, Takatoshi Mizuta, MD, Joel D. Cooper, MD

Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, Barnes Hospital, St. Louis, Missouri USA

Accepted for publication January 18, 1993.

* Address reprint requests to Dr Sundaresan, Division of Cardiothoracic Surgery, Washington University School of Medicine, Suite 3107, Queeny Tower, One Barnes Hospital Plaza, St. Louis, MO 63110.

We used a bilateral lung transplant model to confirm, in primates, the results of lung preservation studies previously obtained in a canine single-lung transplant model. The donor lungs were flushed with low-potassium dextran solution and maintained semiinflated with 100% oxygen at 10 °C for a planned ischemic time of 12 hours for the lung implanted first. Of eight experiments performed, results in the 6 operative survivors form the basis of this report. After bilateral lung transplantation, animals were maintained on a ventilator for 6 hours; arterial oxygen tension, pulmonary artery pressure, and pulmonary vascular resistance were determined in the recipients at 2, 4, and 6 hours after transplantation and compared with donor values, which served as controls. Arterial oxygen tension in the recipients did not differ from the controls (p = not significant), whereas the pulmonary artery pressure and pulmonary vascular resistance showed significant elevation (p < 0.05 versus control values). After the 6 hours of assessment, the animals were exhibited and 3 survived for 48 to 72 hours with a mean arterial oxygen tension of 69 mm Hg on room air. These results demonstrate excellent lung function sfter a minimum of 12 hours of preservation in a primate model in which the animal is totally dependent on the function of transplanted lung tissue, and confirm the potential for prolonged clinical lung preservation.




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