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Ann Thorac Surg 2000;70:1679-1683
© 2000 The Society of Thoracic Surgeons
a Department of Surgery II, Okayama University School of Medicine, Okayama, Japan
Address reprint requests to Dr Date, Department of Surgery II, Okayama University School of Medicine, 2-5-1 Shikata-cho, Okayama 700-8558, Japan
e-mail: hdate{at}nigeka.hospital.okayama-u.ac.jp
Background. Use of lungs harvested from non-heart-beating donors (NHBDs) would increase the pulmonary donor pool; however, this strategy would have higher risk of early postoperative graft dysfunction due to unavoidable warm ischemic time. We evaluated the effects of short-term inhaled nitric oxide (NO) during reperfusion in canine left single-lung allotransplantation from a non-heart-beating donor.
Methods. The donor dogs were sacrificed without heparinization and left at room temperature for 3 hours. Then, recipient dogs received a left single-lung allotransplantation. After implantation, the right bronchus and pulmonary artery were ligated. In group 1 (n = 6), NO gas was administered continuously at a concentration of 40 parts per million throughout a 6-hour assessment period. In group 2 (n = 6), NO gas was administered for the initial 1 hour during reperfusion. In group 3 (n = 6), nitrogen gas was administered for control.
Results. Groups treated with NO exhibited lower pulmonary vascular resistance, as well as improved survival and oxygenation. There was no significant difference in these parameters between group 1 and group 2. Myeloperoxidase activity was significantly lower in NO-treated groups.
Conclusions. Inhaled NO during reperfusion is beneficial in lung transplantation from non-beating heart donors. The beneficial effect is obtained mainly during the first hour of reperfusion.
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