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Ann Thorac Surg 2000;69:910-912
© 2000 The Society of Thoracic Surgeons

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Original Articles

Technique of controlled reperfusion of the transplanted lung in humans

^a Divisions of Division of Cardiothoracic Surgery, The University of Texas Medical Branch, Galveston, Texas, USA
^b Division of Cardiothoracic Anesthesiology, The University of Texas Medical Branch, Galveston, Texas, USA

Address reprint requests to Dr Lick, Division of Cardiothoracic Surgery, University of Texas Medical Branch, Galveston, TX 77555-0528.
e-mail: slick{at}utmb.edu

Background. Reperfusion injury remains a significant and sometimes fatal problem in clinical lung transplantation. Controlled reperfusion of the transplanted lung using white cell–filtered, nutrient-enriched blood has been shown recently to significantly ameliorate reperfusion damage in a porcine model. We modified this experimental technique and applied it to human lung transplantation.

Methods. Approximately 1,500 mL of arterial blood was slowly collected in a cardiotomy reservoir during the lung implant, and mixed to make a 4:1 solution of blood:modified Buckberg perfusate. This solution was passed through a leukocyte filter and into the transplant pulmonary artery for 10 minutes, at a controlled rate (200 mL/min) and pressure (less than 20 mm Hg), immediately before removal of the vascular clamp.

Results. Five patients underwent lung transplantation (1 bilateral, 4 single lung) using this technique. All patients were ventilated on a 40% fraction of inspired oxygen within a few hours and extubated on or before the first postoperative day.

Conclusions. Controlled reperfusion of the transplanted lung with white cell–filtered, nutrient-enriched blood has given excellent functional results in our small initial clinical series.

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