TY - JOUR
T1 - Unilateral lung transplantation using right and left upper lobes
T2 - An experimental study
AU - Nishikawa, Hitoshi
AU - Oto, Takahiro
AU - Otani, Shinji
AU - Harada, Masaaki
AU - Iga, Norichika
AU - Miyoshi, Kentaroh
AU - Miyoshi, Shinichiro
N1 - Funding Information:
All the pigs received humane care in compliance with the European Convention on Animal Care and the Principles of Laboratory Animal Care, formulated by the National Society for Medical Research, and the Guide for the Care and Use of Laboratory Animals, prepared by the Institute of Laboratory Animal Resources and published by the National Institutes of Health (Bethesda, Md; National Institutes of Health publication no. 86-23, revised 1996).
PY - 2013/12
Y1 - 2013/12
N2 - Objective The shortage of organ donors is a serious problem in Japan. The right and left upper lobes of rejected extended-criteria lungs have the potential to be used for downsized lung transplantation; however, the 2 upper lobes are too small for a size-matched recipient. The present study investigated the feasibility of unilateral transplantation using the right and left upper lobes. Methods After harvesting the heart-lung block from donor swine, a left lung graft was created using the right and left upper lobes and transplanted into the left thoracic space of the recipient swine (group A, n = 5). We then evaluated graft function for 6 hours and compared these results with those of a control group (group B, n = 5), in which orthotopic left lung transplantation had been performed. Results The mean partial pressure of oxygen in the arterial blood gas after reperfusion was 507 mm Hg in group A and 463 mm Hg in group B (P =.2). The mean pulmonary arterial pressure was 30.3 mm Hg in group A and 27.5 mm Hg in group B (P =.4). The mean airway pressure was 6.4 mm Hg in group A and 6.2 mm Hg in group B (P =.7). Conclusions Our results suggest that unilateral left lung transplantation using the right and left upper lobes is technically and functionally feasible for size-matched recipients. In addition, this technique enables the use of rejected lungs if the upper lobes are still intact.
AB - Objective The shortage of organ donors is a serious problem in Japan. The right and left upper lobes of rejected extended-criteria lungs have the potential to be used for downsized lung transplantation; however, the 2 upper lobes are too small for a size-matched recipient. The present study investigated the feasibility of unilateral transplantation using the right and left upper lobes. Methods After harvesting the heart-lung block from donor swine, a left lung graft was created using the right and left upper lobes and transplanted into the left thoracic space of the recipient swine (group A, n = 5). We then evaluated graft function for 6 hours and compared these results with those of a control group (group B, n = 5), in which orthotopic left lung transplantation had been performed. Results The mean partial pressure of oxygen in the arterial blood gas after reperfusion was 507 mm Hg in group A and 463 mm Hg in group B (P =.2). The mean pulmonary arterial pressure was 30.3 mm Hg in group A and 27.5 mm Hg in group B (P =.4). The mean airway pressure was 6.4 mm Hg in group A and 6.2 mm Hg in group B (P =.7). Conclusions Our results suggest that unilateral left lung transplantation using the right and left upper lobes is technically and functionally feasible for size-matched recipients. In addition, this technique enables the use of rejected lungs if the upper lobes are still intact.
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U2 - 10.1016/j.jtcvs.2013.08.042
DO - 10.1016/j.jtcvs.2013.08.042
M3 - Article
C2 - 24079876
AN - SCOPUS:84888024891
SN - 0022-5223
VL - 146
SP - 1534
EP - 1537
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
IS - 6
ER -