1996 Fiscal Year Final Research Report Summary
Study in possibility of lung transplantation from non-heart beating donor (primate model)
| Project/Area Number |
06557069
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| Research Category |
Grant-in-Aid for Scientific Research (A)
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| Allocation Type | Single-year Grants |
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| Section | 試験 |
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| Research Field |
Thoracic surgery
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| Research Institution | Institute of Development, Aging and Cancer, Tohoku University |
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Principal Investigator |
KONDO Takashi Institute of Development, Aging and Cancer, Tohoku University, AssistantProfessor, 加齢医学研究所, 助手 (10195901)
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| Co-Investigator(Kenkyū-buntansha) |
SAITO Ryo Institute of Development, Aging and Cancer, Tohoku University, Assistant Profess, 加齢医学研究所, 助手 (70225689)
FUJIMURA Shigefumi Institute of Development, Aging and Cancer, Tohoku University, Professor, 加齢医学研究所, 教授 (40006078)
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| Project Period (FY) |
1994 – 1996
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| Keywords | Lung Transplantation / Non-Heart-Beating Donor / Bilateral Lung Transplantation |
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| Research Abstract |
The major impediment of lung transplantation is lack in candidate of suitable pulmonary donors. The purpose of this experiment is to evaluate whether there is life-sustaining function of the transplanted lungs harvested from circulatory arrested donors which had been brain dead.
Materials and Methods
Eighteen Japanese monkeys (7-10kg) were divided into two groups. In group I,animals underwent one-stage sequential bilsteral lung transplantation from heart beating donors (n=6). Recipient animals in group II received bilateral pulmonary allografts harvested immediately after cardiac arrest from the brain dead donor (n=6). The brain death model was created with a ballon expanded in the intracranial epidural space for the donors of group II.The hearvested lungs in both groups were perfused with 500-700 ml of 6-C Ep4 solution with a composition similar to extracellular fluid. In both groups, first, the right lung transplantation was performed through right thoracotomy, and then the left lung t
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ransplantation was sequentially carried out through left thoracotomy. After bilateral transplantation, animals were maintained on a ventilator for 36 hours and were assessed. Arterial oxygen tension, pulmonary artery pressure (every 3 hours) and pulmonary vascular resistance (every 12hours) were measured. After these measurements, recipients were extubated. The immunosuppression protocol of this experiment consisted of Cyclosporin A, Azathioprine and steroids.
Results
Of twelve animals with one-stage sequential bilateral lung transplantation, ten could tolerate the operation. Remaining one died of cardiac failure due to stenosis at the anastomosis of the right pulmonary artery or vein during the transplantation procedure. Early lung function was excellent in both groups. The mean arterial oxygen tension (FiO2 : 0.4) after 12hours was 191 ア 16Torr in group I (n=4) and 180 ア 31Torr in group II (n=4). Total pulmonary vascular resistance after 12 and 24hours were 1537 ア 465 and 1419 ア 349 dyne.sec.cm^<-5> in Group I,and 1537 ア 672 and 1241 ア 631 dyne.sec.cm^<-5> in group II.In group I,one died after 32hours and the other died on 3,9,20,50 postoperative days. In group II,three died within one week and the other died on the 94th day.
Conclousion
Excellent pulmonary function was obtained from the recipients with transplantation of bilateral lungs from brain dead donors harvested after cardiac arrest. These results may explore the criteria of the suitable candidate for lung transplantation. Less
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