LPDG 용액을 이용한 성견의 양측 및 일측 폐이식 비교

Abstract

Purpose: Canine left single lung allotransplantation has become a frequently used model, but has some limitation. The purpose of this study is to verify and compare canine sequential bilateral allotrasplant model with canine left single lung transplant model. We prepared LPDG (low potassium dextran glucose)solution for lung preservation study, in this study we examined the efficacy of LPDG solution in 24-hour lung preservation by using a sequential bilateral canine lung allotransplant model. Methods: Seven bilateral lung transplant procedures were performed using adult mongrel dogs. Comparative group was 9 cases of left single lung. The donor lungs were flushed with LPDG solution and maintained hyperinflated with 100% oxygen at 10°C for a planned ischemic time of 24 hours. After sequential bilateral lung transplantation, dogs were maintained on ventilators for 3 hours: arterial resistance were determined and compared with donor values which were used as controls. After 2 hours of reper-fusion, the chest X-ray, computed tomogram and lung perfusion scan were checked. Pathological examinations for ultra-structural findings of alveolar structure and endothelial structure of pulmonary artery were performed. Results: Five of seven experiments successfully finished the whole assessments after bilateral reperfusion for 3 hours. Arterial oxygen tension in the recipients was markedly decreased in immediate reperfusion period but gradually recovered after reperfusion for 3 hours. The pulmonary arterial pressure and pulmonary vascular resistance showed significant elevation (P <0.05 vs. control values) but also recovered after reperfusion for three houre (P<0.05 vs. immediate period value). The ultrastructural findings of alveolar structure and endothelial structure of pulmonary artery showed reversible mild injury in 24 hours of lung perservation and reperfusion on both groups. Conclusion: The present study suggests that LPDG solution provide excellent preservation in a canine sequential bilateral lung transplant model in which the dog is completely dependent on the function of the transplanted lung and under physiologic condition. Sequential bilateral lung transplant model was more appropriate and accurate experimental model compared to single lung transplant model.