A strategy to increase the donor pool: use of cadaver lungs for transplantation

Ann Thorac Surg. 1991 Nov;52(5):1113-20; discussion 1120-1. doi: 10.1016/0003-4975(91)91290-c.

Abstract

A shortage of suitable donors is a serious obstacle to the widespread application of isolated lung transplantation for end-stage lung disease. We hypothesized that lung tissue likely remains viable for a sufficient period of time to allow for safe postmortem retrieval of lungs for transplantation. Studies were conducted in a nonsurvival model of canine lung allotransplantation. Donor animals were sacrificed, and subsequent lung harvest was delayed for 1 hour, 2 hours, or 4 hours. Pulmonary retrieval was then performed in a standard fashion, flushing the lung block with modified Euro-Collins solution. Lungs were then stored for 4 hours before single allotransplantation. Recipient animals were maintained anesthetized, and followed up for 8 hours. By occlusion of the pulmonary artery and bronchus to the native lung, recipient animals were forced to survive solely on the transplanted lung, with a constant inspired oxygen fraction of 0.40. All 5 recipient animals of 1-hour cadaver lungs survived the 8-hour observation period with excellent hemodynamics and gas exchange. Two of 5 recipients of 2-hour cadaver lungs survived the observation period, whereas a third animal survived for 5 hours with excellent gas exchange. One of 4 animals transplanted with a 4-hour cadaver lung survived the observation period. Retrieval of lungs from cadavers whose hearts are not beating may prove to be a safe and effective method to increase the pulmonary donor pool.

MeSH terms

  • Animals
  • Cadaver
  • Cold Temperature
  • Dogs
  • Hemodynamics / physiology
  • Hypertonic Solutions
  • Lung Transplantation* / mortality
  • Lung Transplantation* / physiology
  • Organ Preservation
  • Pulmonary Gas Exchange / physiology
  • Time Factors
  • Tissue and Organ Procurement
  • Transplantation, Homologous

Substances

  • Euro-Collins' solution
  • Hypertonic Solutions