2006 - UZ Leuven

upon reperfusion results from a reduced number of residualmicrothrombi in the pulmonary vasculature.Table 1ReperfusiontimePVR(dynes*seccm -5PO 2/FiO 2(mmHg)Plat AwP(cmH 2O)Compi(ml/cmH 2 O)NFAFRFNFAFRFNFAFRFNFAFRF40’ 45’ 50’ 55’ 60’1482 ± 611528 ±1701387 ± 85610 ±24619 ±32697 ± 2814 ± 114 ± 013 ±117 ± 116 ±120 ± 21418 ± 761581 ±1111225 ± 54°607 ± 20640 ± 31686 ± 3414 ± 114 ± 013 ± 118 ± 216 ± 121 ± 31351 ± 871565 ± 1001249 ± 57°618 ± 25632 ±31658 ± 3313 ± 114 ± 113 ± 118 ± 117 ± 222 ±31448 ± 821571 ± 1041186 ± 69°♦627 ± 22630 ± 32662 ± 4314 ± 114 ± 113 ± 118 ± 117 ± 220 ± 31435 ± 951560 ±1231145 ± 56°♦621 ± 25636 ± 35673 ± 4214 ± 114 ± 013 ± 117 ± 218 ± 124 ± 3VAN DE WAUWER C., NEYRINCK A., GEUDENS N., REGA F.,VERLEDEN G.M., LERUT T. VAN RAEMDONCK D.: Modification of thearterial anastomotic technique improves survival in a porcine singlelung transplant model. Acta Chir. Belg., 2006; 106: 450-457.Background: Lung transplantation is a valuable therapeutic option forselected patients with end-stage pulmonary disease. However, thistreatment is complicated by ischaemia-reperfusion injury (IRI) of thelung in 10-20% of the recipients. We developed an unilateral porcinelung transplant model to study IRI and describe our experience withtwo different arterial anastomotic techniques.Material and methods: Twenty four domestic pigs (n=6x(donor +recipient)/group) were used in this study. Donor lungs were harvestedusing an antegrade flush with cold Perfadex ® and stored in the samesolution for ± 8 hours. Recipient animals underwent a leftthoracotomy. After native pneumonectomy, the left donor lung wastransplanted in the following order: 1. left arterial cuff; 2. bronchus; 3.pulmonary artery. 2 The outcome in recipients from historical groupsdiffering in anastomotic technique was compared. An end-to-endanastomosis on the left pulmonary artery was performed in group Iversus a patch anastomosis on the main pulmonary artery in group II.One hour after reperfusion, the right pulmonary artery and mainbronchus were ligated forcing the recipient to survive on thetransplanted lung only. The animals were further observed for 6 hours.Results: Survival 6 hours after exclusion of the right lung was 33%(2/6) in group I versus 83% (5/6) in group II. Animals in group I died of113