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Ann Thorac Surg 2003;76:244-252
© 2003 The Society of Thoracic Surgeons

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Original article: general thoracic

Transplantation of lungs from non–heart-beating donors after functional assessment ex vivo

^a Department of Cardiothoracic Surgery, Heart-Lung Division, University Hospital of Lund, Lund, Sweden

Accepted for publication January 24, 2003.

^* Address reprint requests to Dr Steen, Department of Cardiothoracic Surgery, Heart-Lung Division, University Hospital of Lund, SE-221 85 Lund, Sweden.
e-mail: stig.steen{at}thorax.lu.se

BACKGROUND: If lungs from patients dying of heart attacks are to serve as donor organs in a safe way, their function should be properly assessed before transplantation. The aim of this study was to investigate donor lung function evaluation in a realistic large animal model.

METHODS: Twelve 60-kg pigs were used. Five minutes after ventricular fibrillation was induced, cardiopulmonary resuscitation was initiated and maintained for 20 minutes. After a 10-min hands-off period, heparin was administered through a central venous catheter followed by 20 chest compressions. Intrapleural cooling was initiated after 65 minutes of warm ischemia. Cooling proceeded for 6 hours within the cadaver, after which lung function was assessed ex vivo. Recipient pigs underwent left lung transplantation followed by right pneumonectomy, thus making these animals 100% dependent for their survival on the function of the donor lungs.

RESULTS: The assessment showed that all lungs had adequate function to serve as donor lungs. All recipient animals were in good condition during the 24-hour observation period after the operation. The blood gas function did not differ significantly from that in the healthy donor animals before induction of ventricular fibrillation; pulmonary vascular resistance was within normal range.

CONCLUSIONS: Lungs from non–heart-beating donors topically cooled in situ for 6 hours after 65 minutes of warm ischemia were assessed ex vivo and found to have normal function. They were then transplanted and retained normal function during a 24-hour observation period.

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