Post-mortem Administration of Urokinase in Canine Lung Transplantation From Non-heart-beating Donors

Ryujiro Sugimoto, Hiroshi Date, Seiichiro Sugimoto, Mikio Okazaki, Keiju Aokage, Hidetoshi Inokawa, Motoi Aoe, Yoshifumi Sano

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: We previously reported that post-mortem heparinization by closed-chest cardiac massage within 30 minutes after cardiac arrest is beneficial in lung transplantation (LTx) from non-heart-beating donors (NHBDs) by preventing formation of microthrombi. In this study, we evaluated the effects of post-mortem administration of urokinase 60 minutes after cardiac arrest. Methods: Left LTx was performed in 12 pairs of mongrel dogs. Donors were sacrificed and left at room temperature for 2 hours. In Group 1 (n = 6), heparin sodium (1,000 U/kg) was administered intravenously 60 minutes after cardiac arrest, then closed-chest cardiac massage was performed for 1 minute to distribute the heparin. In Group 2 (n = 6), the donors were treated as in Group 1, except, in addition to heparin sodium, urokinase (120,000 U) was administered intravenously before and at the end of cardiac massage. After 2 hours of cardiac arrest, donor lungs were flushed with low-potassium dextran glucose solution. After left LTx, the right pulmonary artery was ligated, and recipients were followed up for 3 hours. Uni- and multivariate repeat analyses were performed to obtain statistical data. Results: Group 2 had significantly better arterial oxygen tension, lower pulmonary vascular resistance and lower wet/dry weight ratio of the transplanted lung than Group 1. d-dimer level during the warm ischemia was significantly lower in Group 2 than in Group 1. Conclusions: Post-mortem administration of urokinase along with heparin is beneficial in LTx from NHBDs by fibrinolytic action on already formed pulmonary microthrombi in the cadaver donor lungs.

Original languageEnglish
Pages (from-to)1148-1153
Number of pages6
JournalJournal of Heart and Lung Transplantation
Volume25
Issue number9
DOIs
Publication statusPublished - Sep 2006

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Lung Transplantation
Urokinase-Type Plasminogen Activator
Heart Massage
Heart Arrest
Heparin
Canidae
Lung
Thorax
Warm Ischemia
Cadaver
Vascular Resistance
Pulmonary Artery
Arterial Pressure
Multivariate Analysis
Dogs
Oxygen
Weights and Measures
Temperature

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Transplantation

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Post-mortem Administration of Urokinase in Canine Lung Transplantation From Non-heart-beating Donors. / Sugimoto, Ryujiro; Date, Hiroshi; Sugimoto, Seiichiro; Okazaki, Mikio; Aokage, Keiju; Inokawa, Hidetoshi; Aoe, Motoi; Sano, Yoshifumi.

In: Journal of Heart and Lung Transplantation, Vol. 25, No. 9, 09.2006, p. 1148-1153.

Research output: Contribution to journalArticle

Sugimoto, Ryujiro ; Date, Hiroshi ; Sugimoto, Seiichiro ; Okazaki, Mikio ; Aokage, Keiju ; Inokawa, Hidetoshi ; Aoe, Motoi ; Sano, Yoshifumi. / Post-mortem Administration of Urokinase in Canine Lung Transplantation From Non-heart-beating Donors. In: Journal of Heart and Lung Transplantation. 2006 ; Vol. 25, No. 9. pp. 1148-1153.
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