Nishikawa, Hitoshi Okayama Univ, Grad Sch Med, Dept Gen Thorac Surg
Otani, Shinji Okayama Univ, Grad Sch Med, Dept Gen Thorac Surg
Harada, Masaaki Okayama Univ, Grad Sch Med, Dept Gen Thorac Surg
Iga, Norichika Okayama Univ, Grad Sch Med, Dept Gen Thorac Surg
Miyoshi, Kentaroh Okayama Univ, Grad Sch Med, Dept Gen Thorac Surg Kaken ID
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.
The Journal of Thoracic and Cardiovascular Surgery
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