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

This Article Full Text 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): Dirk E. M. Van Raemdonck Filip R. L. Rega Paul R. J. De Leyn Willem J. Flameng Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Van Raemdonck, D. E. M. Articles by Lerut, T. E. Search for Related Content PubMed PubMed Citation Articles by Van Raemdonck, D. E. M. Articles by Lerut, T. E. Related Collections Related Article

Ann Thorac Surg 1996;62:331-337
© 1996 The Society of Thoracic Surgeons

---

Original Articles: General Thoracic

External Cooling of Warm Ischemic Rabbit Lungs After Death

Center for Experimental Surgery and Anaesthesiology, Katholieke Universiteit Leuven, Leuven, Belgium

Background. If lungs could be retrieved for transplantation after circulatory arrest, the shortage of donors might be significantly alleviated. However, in such non-heart-beating donors, there is great concern that even a short period of warm ischemia will be deleterious for lung tissue, jeopardizing the transplant recipient. It was the purpose of this study to look for the efficacy of different methods of lung cooling inside a cadaver after circulatory arrest.

Methods. New Zealand white rabbits were sacrificed with an intravenous overdose of pentobarbital and left at room temperature. Subcutaneous, rectal, lung core, lung surface, and endobronchial temperatures were measured at intervals after death. Cooling of the lung during ischemia differed between groups (n = 6 in each group): lungs left deflated at room temperature (24°C) (group 1 = control non-heart-beating donors), lungs ventilated with cooled (4°C) room air (group 2), lungs left deflated plus topical cooling (1°C) of both the cadaver and its lungs (group 3), and lungs flushed in situ immediately after circulatory arrest with a cold (4°C) crystalloid solution followed by ex vivo deflated storage in cold (1°C) saline solution (group 4 = control heart-beating donors).

Results. There was a slow decline in lung core, lung surface, and endobronchial temperatures toward room temperature in group 1 (1.5° ± 0.0°C/h, 1.8° ± 0.2°C/h, and 1.9° ± 0.1°C/h, respectively). In contrast, all three lung temperatures immediately (<5 minutes) dropped to less than 10°C in group 4. Hypothermic ventilation (group 2) decreased endobronchial temperature (p < 0.05 at 30 minutes) but not lung surface, rectal, or subcutaneous temperature when compared with group 1. Cooling rate for lung surface and endobronchial temperatures during the first 4 hours after death was faster (p < 0.01) in group 3 (6.6° ± 0.3°C/h and 6.1° ± 0.2°C/h, respectively) when compared with group 2 (2.5° ± 0.3°C/h and 3.9° ± 0.1°C/h, respectively), but slower (p < 0.001) when compared with group 4 (9.2° ± 0.1°C/h and 8.7° ± 0.1°C/h, respectively).

Conclusions. These data demonstrate that in the non-heart-beating donor, (1) in situ cold flush will result in immediate cooling of the lung, (2) ventilation with cooled air will only accelerate the decline in endobronchial temperature but has no effect on lung surface temperature, and (3) topical cooling of the cadaver is more efficacious in decreasing lung temperature than hypothermic ventilation.

Related Article

Invited Commentary

Thomas M. Egan
Ann. Thorac. Surg. 1996 62: 337. [Extract] [Full Text]

This article has been cited by other articles:

				T. Oto, A. Calderone, S. Pepe, G. Snell, and F. Rosenfeldt High-flow endobronchial cooled humidified air protects non-heart-beating donor rat lungs against warm ischemia. J. Thorac. Cardiovasc. Surg., August 1, 2006; 132(2): 413 - 419. [Abstract] [Full Text] [PDF]

				F. R. Rega, A. P. Neyrinck, G. M. Verleden, T. E. Lerut, and D. E. M. Van Raemdonck How long can we preserve the pulmonary graft inside the nonheart-beating donor? Ann. Thorac. Surg., February 1, 2004; 77(2): 438 - 444. [Abstract] [Full Text] [PDF]

				F. R Rega, E. J Vandezande, N. C Jannis, G. M Verleden, T. E Lerut, and D. E. Van Raemdonck The role of leukocyte depletion in ex vivo evaluation of pulmonary grafts from (non-)heart-beating donors Perfusion, January 1, 2003; 18(1_suppl): 13 - 21. [Abstract] [PDF]

				H. Shennib, J.-Q. Kuang, and A. Giaid Successful retrieval and function of lungs from non-heart-beating donors Ann. Thorac. Surg., February 1, 2001; 71(2): 458 - 461. [Abstract] [Full Text] [PDF]

				D. E.M. Van Raemdonck, N. C.P. Jannis, P. R.J. De Leyn, W. J. Flameng, and T. E. Lerut Alveolar expansion itself but not continuous oxygen supply enhances postmortem preservation of pulmonary grafts Eur. J. Cardiothorac. Surg., April 1, 1999; 13(4): 431 - 441. [Abstract] [Full Text] [PDF]

				U. Stammberger, R. A. Schmid, S. Hillinger, T. Singer, O. M. Schob, A. Zollinger, and W. Weder Effect of a short period of warm ischemia after cold preservation on reperfusion injury in lung allotransplantation Eur. J. Cardiothorac. Surg., April 1, 1999; 13(4): 442 - 448. [Abstract] [Full Text] [PDF]

				D. E. M. Van Raemdonck, N. C. P. Jannis, F. R. L. Rega, P. R. J. De Leyn, W. J. Flameng, and T. E. Lerut Extended Preservation of Ischemic Pulmonary Graft by Postmortem Alveolar Expansion Ann. Thorac. Surg., September 1, 1997; 64(3): 801 - 808. [Abstract] [Full Text]