Okamoto T, Chen F, Zhang J, Yamada T, Nakayama E, Morikawa H, Bando T, Date H
Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan.
Transplant Proc. 2010 Jun;42(5):1598-601. doi: 10.1016/j.transproceed.2010.03.140.
Functional evaluation of potentially damaged lungs donated after cardiac death is crucial for widespread clinical transplantation. To date, the mean weight of animals used in studies of ex vivo lung perfusion (EVLP) has been 60 kg; however, in the clinical setting, donor weight may be greater.
To investigate EVLP using lungs from large pigs (mean weight, 115 kg) to simulate human adult lungs donated after cardiac death.
Five heart-lung blocks were obtained at 20 minutes after death at the slaughterhouse. The lungs were flushed and preserved on ice for 6 hours before being connected to an ex vivo lung circuit, and were perfused for at least 2 hours.
In all cases, perfusion was sustained for at least 2 hours. Mean (SEM) final flow rate was 4.9 (0.1) L/min, pulmonary artery pressure was 14.8 (1.7) mm Hg, and oxygen tension/fraction of inspired oxygen was 518.0 (18.0) mm Hg. The shunt fraction was 20.5% (4.0%). Histologic analysis demonstrated no significant pulmonary edema at the end of perfusion.
We successfully completed EVLP using lungs from large pigs.
对心脏死亡后捐献的潜在受损肺进行功能评估对于广泛的临床移植至关重要。迄今为止，体外肺灌注（EVLP）研究中使用的动物平均体重为60千克；然而，在临床环境中，供体体重可能更大。
使用大型猪（平均体重115千克）的肺进行体外肺灌注，以模拟心脏死亡后捐献的成人肺。
在屠宰场猪死亡20分钟后获取5个心肺块。肺被冲洗并在冰上保存6小时，然后连接到体外肺循环，并灌注至少2小时。
在所有病例中，灌注持续至少2小时。平均（标准误）最终流速为4.9（0.1）升/分钟，肺动脉压为14.8（1.7）毫米汞柱，氧分压/吸入氧分数为518.0（18.0）毫米汞柱。分流分数为20.5%（4.0%）。组织学分析显示灌注结束时无明显肺水肿。
我们成功地使用大型猪的肺完成了体外肺灌注。
