Comparison of surgical procedures for vascular and airway anastomoses that utilize a modified non-suture external cuff technique for experimental lung transplantation in rats.

BACKGROUND

Lung transplantation in rats is technically difficult and results may vary. The non-suture cuff technique (non-suture [NS]), which involves using a cuff for anastomoses of vessels and airways, is commonly utilized to perform transplant procedures. However, the standard bronchial cuff may occlude the lumen, resulting in diminished graft survival. In contrast, the non-suture cuff technique for vascular anastomoses with bronchial suturing (bronchial suture [BS]), although more technically difficult, is known to have prolonged bronchial patency. We developed a "modified" NS technique that uses a larger and longer cuff for anastomoses and compared the efficacy of this procedure to the BS technique for lung transplantation.

METHODS

The BS procedure was performed in 146 transplant procedures. The modified NS procedure, which uses a larger cuff than the standard NS procedure, was performed in 113 procedures.

RESULTS

Although total ischemic times were comparable, the total operation time in the NS group was significantly shorter than in the BS group (p < 0.0001). Bronchial leakage occurred in 9.6% of BS group patients and 0% of NS group patients. Survival rates were comparable between groups. Although the BS technique is widely acknowledged to provide prolonged patency of bronchial anastomosis, graft survival in the NS group was observed up 17 months post-transplant.

CONCLUSIONS

These data show that the NS technique, which is less technically difficult, results in shorter operative times compared with the BS procedure, and results in durable anastomoses of lung grafts.