Expeimental Study on Pulmonary Function and Lung Growth after Living-Donor Lobar Lung Transplantation
| Project/Area Number |
12671310
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Thoracic surgery
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| Research Institution | OKAYAMA UNIVERSITY |
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Principal Investigator |
DATE Hiroshi Okayama University Hospital, Lecturer, 医学部・附属病院, 講師 (60252962)
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| Co-Investigator(Kenkyū-buntansha) |
SANO Yoshifumi Okayama University Hospital, Assistant, 医学部・附属病院, 助手 (60322228)
AOE Motoi Okayama University Hospital, Assistant, 医学部・附属病院, 助手 (80260660)
SHIMIZU Nobuyoshi Okayama University, Graduate School of Medicine and Dentistry, Professor, 大学院・医歯学総合研究科, 教授 (90108150)
NAGAHIRO Itaru Okayama University Hospital, Assistant, 医学部・附属病院, 助手 (00311803)
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| Project Period (FY) |
2000 – 2001
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| Project Status |
Completed (Fiscal Year 2001)
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| Budget Amount *help |
¥3,000,000 (Direct Cost: ¥3,000,000)
Fiscal Year 2001: ¥1,400,000 (Direct Cost: ¥1,400,000)
Fiscal Year 2000: ¥1,600,000 (Direct Cost: ¥1,600,000)
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| Keywords | Living-Donor Lobar Lung Transplantation / Donor / Recipient / Pulmonary arteriral pressure / Arterial oxygen tension |
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| Research Abstract |
Experiment 1: In an effort to address the donor shortage issue, living-donor lobar lung transplants have been performed with satisfactory results. The use of small grafts is potentially problematic because it could cause high pulmonary artery pressure resulting in lung edema. The purpose of this study was to evaluate the effect of small grafts on early pulmonary function and to identify the predictor for acceptable size discrepancy. Seventeen pairs of mongrel dog with various donor/recipient (D/R) sizes were used. Body weight, height, chest circumference and lung weight were measured as size parameters. Right middle, lower and cardiac lobes were implanted as a right lung of the recipient and left lower lobe was implanted as a left lung without using cardiopulmonary bypass. Pulmonary function of the recipient was measured for 6 hours after reperfusion. A significant negative correlation was found between D/R body weight ratio and mean pulmonary artery pressure at one hour (r=-0.594 ; p=
… More
0.025). A significant correlation was found between D/R body weight ratio and arterial oxygen tension (Pa02) at 6 hours (r=0.704 ; p=0.007). There was no significant correlation between the other three size parameters and postoperative pulmonary function. All 8 recipients with D/R body weight ratio > 1.2 survived the 6-hour assessment period and their PaO2 exceeded 500 mmHg at 6 hours. D/R weight ratio is an important predictor of early pulmonary function in a canine living-donor lobar lung transplant model.
Experiment 2 : For infants and small children, organ transplantation is limited by the size discrepancy between donor and recipient. To address this problem, the use of over-sized grafts from living-related donors could potentially expand the donor pool. The aim of this experimental study was to evaluate the effect of over-sized grafts on early pulmonary function and to identify an indicator for an acceptable size discrepancy. Fourteen bilateral lobar lung allotransplant operations were performed without cardiopulmonary bypass in weight mis-matched pairs of dogs. Animals were divided into two groups : Group I (n=7), Donor/Recipient lung volume ratio < 2.85 ; Group II (n=7), Donor/Recipient lung volume ratio > 2.85. Pulmonary function of the recipient was measured before chest closure, after chest closure, and after the ventilator was removed. Pulmonary vascular resistance and airway pressure significantly increased in group II after, chest closure (1493±195 dynes sec.cm-5 and 14.4± 0.9 mmHg versus 2784±140 dynes.sec.cm-5 and 23.4±1.2 mmHg, p<0.001). After the ventilator was removed, all recipients in group I showed Pa02 > 239 mmHg and PaC02 < 76 mmHg, whereas all recipients in group II showed Pa02 <116 mmHg and PaCO2 > 169 mmHg. The Donor/recipient chest circumference ratio was less than 1.3 in all but one dog in group I. Acceptable over-sized grafts provide adequate pulmonary function, although excessively over-sized grafts cause significant impairment in pulmonary function after the chest closure. Chest circumference provides a useful size match criteria when over-sized grafts are used in this canine experimental model. Less
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Report
(3 results)
Research Products
(6 results)
