The changes in main pulmonary artery pressure after bilateral lung autotransplantation in dogs

ABSTRACT

In the Respiratory Center, Yongdong Severance Hospital, Yonsei University, we performed 10 cases of bilateral lung autotransplantation in mongrel dogs from July 1994 to June 1996, and we have analyzed the hemodynamic changes. Autotransplantation was performed in order to avoid postoperative rejection. The lung was flushed with an Euro-Collins(E-C) solution containing PGE1 which passed through a 10 French catheter inserted into an incision on the anterior half of the pulmonary artery to pulmonary parenchyme, and the vertical incision was made on the anterior half of the left atrium near the proximal part of the pulmonary vein. However, the bronchus was totally divided after clamping both sides. The lung was kept cold (4 degrees C) in the thoracic cavity for an hour by using slushed ice made from an E-C solution. After an hour of cold ischemia, the pulmonary artery was sutured with Prolene 5-0. The pulmonary vein was sutured with Prolene 6-0 by using the continuous everting mattress method. The main bronchus was anastomosed using the telescope method. The arterial oxygen concentration and the pressures in the femoral and pulmonary arteries were measured both preoperatively and postoperatively. There were no significant hemodynamic differences between the preoperative and postoperative mean pulmonary artery pressure (MPAP) (paired t-test, P = 0.05). Lung preservation using a cold (4 degrees C) E-C solution containing PGE1 may be an acceptable method for short-term storage of a lung (for about an hour) in bilateral lung autotransplantation in dogs.