Yang Xiucheng, Liu Mingzhao, Zhao Jin, Tian Dong, Yue Bingqing, Shao Jingbo, Wei Dong, Huang Man, Chen Jingyu
Center for Lung Transplantation, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Thoracic Surgery, People's Hospital of Rizhao, Rizhao, China.
JTCVS Tech. 2024 Jul 10;27:211-216. doi: 10.1016/j.xjtc.2024.07.002. eCollection 2024 Oct.
Extracorporeal membrane oxygenation (ECMO) has become an important life support technique during lung transplantation. We aimed to develop a rat model for lung transplantation using venoarterial (VA) ECMO support.
Adult male Sprague-Dawley rats weighing 400 to 450 g were used in this study. ECMO circuits were created by obtaining venous access from the femoral vein with subsequent extracorporeal oxygen exchange, which was then returned to the circulatory system through the left carotid artery (ie, VA-ECMO). Simultaneously, the donor lungs were retrieved and immersed in cold, low-potassium dextran lung preservation solution. Orthotopic left lung transplantation supported by VA-ECMO was performed. Thereafter, a respiratory failure rat model was constructed using ventilation with a hypoxic and hypercapnic gas mixture, consisting of 6% oxygen, 8% carbon dioxide, and 86% nitrogen, before lung transplantation. Similarly, left lung transplantation supported by VA-ECMO was performed in rats with respiratory failure. Arterial blood gas levels were measured at designated time points throughout the experiment.
We found that VA-ECMO provided sufficient oxygenation and carbon dioxide removal to allow for smooth left lung transplantation in healthy rats and those with respiratory failure.
We established a rat model for lung transplantation using VA-ECMO. Left lung transplantation using VA-ECMO support is also feasible and safe in rat models of respiratory failure. These models provide efficient and economical models for translational medicine for lung transplantation using ECMO. Moreover, it will be invaluable to evaluate the physiological and pathophysiological roles of ECMO during lung transplantation.
体外膜肺氧合（ECMO）已成为肺移植过程中的一项重要生命支持技术。我们旨在建立一种使用静脉-动脉（VA）ECMO支持的大鼠肺移植模型。
本研究使用体重400至450克的成年雄性Sprague-Dawley大鼠。通过从股静脉获取静脉通路并进行体外氧交换来创建ECMO回路，然后通过左颈动脉将其返回循环系统（即VA-ECMO）。同时，获取供体肺并将其浸入冷的低钾右旋糖酐肺保存液中。进行由VA-ECMO支持的原位左肺移植。此后，在肺移植前，使用由6%氧气、8%二氧化碳和86%氮气组成的低氧高碳酸气体混合物进行通气，构建呼吸衰竭大鼠模型。同样，对呼吸衰竭大鼠进行由VA-ECMO支持的左肺移植。在整个实验过程中的指定时间点测量动脉血气水平。
我们发现VA-ECMO提供了足够的氧合和二氧化碳清除，以允许在健康大鼠和呼吸衰竭大鼠中顺利进行左肺移植。
我们建立了一种使用VA-ECMO的大鼠肺移植模型。在呼吸衰竭大鼠模型中，使用VA-ECMO支持进行左肺移植也是可行且安全的。这些模型为使用ECMO的肺移植转化医学提供了高效且经济的模型。此外，评估ECMO在肺移植过程中的生理和病理生理作用将具有重要价值。
