May 26, 2009

Prolonged venoarterial extracorporeal membrane oxygenation after transplantation restores functional integrity of severely injured lung allografts and prevents the development of pulmonary graft failure in a pig model

The Journal of Thoracic and Cardiovascular Surgery
György LangWalter Klepetko

Abstract

Prolonged venoarterial extracorporeal membrane oxygenation support during transplantation provides reduction of pulmonary artery flow and allows for protective ventilation. This approach might have the potential to restore function of lungs that would be unsuitable for transplantation. Left lung transplantation was performed on 16 pigs. Lungs from brain-dead animals were stored for 22 hours at 4 degrees C. Recipients in group A (n = 8) underwent transplantation without cardiopulmonary support followed by ventilation with 10 mL/kg body weight tidal volume. Animals in group B (n = 8) underwent transplantation during venoarterial extracorporeal membrane oxygenation, which was continued for 22 hours, and received low-tidal-volume (5 mL/kg body weight) ventilation. One hour after transplantation, the right lung was excluded. Graft function was compared immediately after exclusion of the contralateral lung (time point 1), 1 hour later (time point 2), and 1 hour after discontinuation of extracorporeal membrane oxygenation (time point 3). Four animals in group A did not reach time point 2; all died of pulmonary edema. All animals in group B survived, and at time point 3, the mean Pao(2) value was 323 +/- 129 mm Hg. At time point 2, oxy...Continue Reading

Mentioned in this Paper

Hemodynamic Instability
Pulmonary Edema
Reperfusion Injury
Entire Right Internal Carotid Artery
Cockayne Syndrome
Alveolar Ventilation Function
Heparin
Structure of Transplanted Lung
Lung
Intraoperative Care

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