Optimal time for post-mortem heparinization in canine lung transplantation with non-heart-beating donors

Mikio Okazaki, Hiroshi Date, Hidetoshi Inokawa, Daisuke Okutani, Keiju Aokage, Itaru Nagahiro, Motoi Aoe, Yoshifumi Sano, Nobuyoshi Shimizu

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: We previously reported that post-mortem heparinization by closed-chest cardiac massage is beneficial in lung transplantation from non-heart-beating donors by preventing formation of microthrombi. In this study, we evaluated the optimal time for post-mortem heparinization in canine lung transplantation from non-heart-beating donors. Methods: Left lung transplantation was performed in 25 weight-matched pairs of mongrel dogs. Donors were killed with an intravenous injection of potassium chloride and left at room temperature for 2 hours. The cadaver donors were assigned randomly to one of five study groups. In Group H0, heparin sodium (1,000 U/kg) was given intravenously before cardiac arrest. In Groups H10, H30, H45 and H60, heparin sodium (1,000 U/kg) was given intravenously 10, 30, 45 and 60 minutes after cardiac arrest, respectively, followed by closed-chest cardiac massage for 2 minutes. After 2 hours of cardiac arrest, donor lungs were flushed with low-potassium dextran glucose solution and preserved for 60 minutes. After left lung allotransplantation, the right pulmonary artery was ligated, and recipient animals were followed up for 3 hours. Uni- and multivariate repeat analyses were utilized for statistical assessment. Results: After transplantation, gas exchange was significantly worse in Groups H45 and H60 than in Groups H0, H10 and H30. Thrombin/anti-thrombin III complex concentration during warm ischemia was significantly higher in Groups H30, H45 and H60 than in Groups H0 and H10. Conclusions: The optimal time for post-mortem heparinization in lung transplantation from non-heart-beating donors is approximately 30 minutes after cardiac arrest.

Original languageEnglish
Pages (from-to)454-460
Number of pages7
JournalJournal of Heart and Lung Transplantation
Volume25
Issue number4
DOIs
Publication statusPublished - Apr 1 2006

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Lung Transplantation
Heart-Lung Transplantation
Heart Arrest
Canidae
Heart Massage
Thrombin
Heparin
Thorax
Warm Ischemia
Lung
Potassium Chloride
Cadaver
Intravenous Injections
Pulmonary Artery
Multivariate Analysis
Transplantation
Gases
Dogs
Weights and Measures
Temperature

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Transplantation

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Optimal time for post-mortem heparinization in canine lung transplantation with non-heart-beating donors. / Okazaki, Mikio; Date, Hiroshi; Inokawa, Hidetoshi; Okutani, Daisuke; Aokage, Keiju; Nagahiro, Itaru; Aoe, Motoi; Sano, Yoshifumi; Shimizu, Nobuyoshi.

In: Journal of Heart and Lung Transplantation, Vol. 25, No. 4, 01.04.2006, p. 454-460.

Research output: Contribution to journalArticle

Okazaki, Mikio ; Date, Hiroshi ; Inokawa, Hidetoshi ; Okutani, Daisuke ; Aokage, Keiju ; Nagahiro, Itaru ; Aoe, Motoi ; Sano, Yoshifumi ; Shimizu, Nobuyoshi. / Optimal time for post-mortem heparinization in canine lung transplantation with non-heart-beating donors. In: Journal of Heart and Lung Transplantation. 2006 ; Vol. 25, No. 4. pp. 454-460.
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AU - Date, Hiroshi

AU - Inokawa, Hidetoshi

AU - Okutani, Daisuke

AU - Aokage, Keiju

AU - Nagahiro, Itaru

AU - Aoe, Motoi

AU - Sano, Yoshifumi

AU - Shimizu, Nobuyoshi

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N2 - Background: We previously reported that post-mortem heparinization by closed-chest cardiac massage is beneficial in lung transplantation from non-heart-beating donors by preventing formation of microthrombi. In this study, we evaluated the optimal time for post-mortem heparinization in canine lung transplantation from non-heart-beating donors. Methods: Left lung transplantation was performed in 25 weight-matched pairs of mongrel dogs. Donors were killed with an intravenous injection of potassium chloride and left at room temperature for 2 hours. The cadaver donors were assigned randomly to one of five study groups. In Group H0, heparin sodium (1,000 U/kg) was given intravenously before cardiac arrest. In Groups H10, H30, H45 and H60, heparin sodium (1,000 U/kg) was given intravenously 10, 30, 45 and 60 minutes after cardiac arrest, respectively, followed by closed-chest cardiac massage for 2 minutes. After 2 hours of cardiac arrest, donor lungs were flushed with low-potassium dextran glucose solution and preserved for 60 minutes. After left lung allotransplantation, the right pulmonary artery was ligated, and recipient animals were followed up for 3 hours. Uni- and multivariate repeat analyses were utilized for statistical assessment. Results: After transplantation, gas exchange was significantly worse in Groups H45 and H60 than in Groups H0, H10 and H30. Thrombin/anti-thrombin III complex concentration during warm ischemia was significantly higher in Groups H30, H45 and H60 than in Groups H0 and H10. Conclusions: The optimal time for post-mortem heparinization in lung transplantation from non-heart-beating donors is approximately 30 minutes after cardiac arrest.

AB - Background: We previously reported that post-mortem heparinization by closed-chest cardiac massage is beneficial in lung transplantation from non-heart-beating donors by preventing formation of microthrombi. In this study, we evaluated the optimal time for post-mortem heparinization in canine lung transplantation from non-heart-beating donors. Methods: Left lung transplantation was performed in 25 weight-matched pairs of mongrel dogs. Donors were killed with an intravenous injection of potassium chloride and left at room temperature for 2 hours. The cadaver donors were assigned randomly to one of five study groups. In Group H0, heparin sodium (1,000 U/kg) was given intravenously before cardiac arrest. In Groups H10, H30, H45 and H60, heparin sodium (1,000 U/kg) was given intravenously 10, 30, 45 and 60 minutes after cardiac arrest, respectively, followed by closed-chest cardiac massage for 2 minutes. After 2 hours of cardiac arrest, donor lungs were flushed with low-potassium dextran glucose solution and preserved for 60 minutes. After left lung allotransplantation, the right pulmonary artery was ligated, and recipient animals were followed up for 3 hours. Uni- and multivariate repeat analyses were utilized for statistical assessment. Results: After transplantation, gas exchange was significantly worse in Groups H45 and H60 than in Groups H0, H10 and H30. Thrombin/anti-thrombin III complex concentration during warm ischemia was significantly higher in Groups H30, H45 and H60 than in Groups H0 and H10. Conclusions: The optimal time for post-mortem heparinization in lung transplantation from non-heart-beating donors is approximately 30 minutes after cardiac arrest.

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