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Back to 2014 Annual Meeting Abstracts
Rat Lung transplantation after Normothermic Preservation with Perfusion and Ventilation
Tatsuya Okamoto, MD1,2, Atsushi Yasuda, MD1,3, Douglas J Mathisen, MD1,2, Harald C. Ott, MD1,2
1Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, 2Department of Surgery, Division of Thoracic Surgery, Massachusetts General Hospital, Boston, MA, 3Department of Anesthesiology, Massachusetts General Hospital, Boston, MA, Boston Children's Hospital, Department of Surgery, Boston, MA
BACKGROUND:
Normothermic (NT) lung perfusion and ventilation has emerged as an important strategy for extension of donor organ pools. However, clinical evidence supporting the benefit of this technology is limited, and no small animal models have been established. The main objective of this study was to develop a reproducible rat lung transplantation model allowing the systematic study of NT lung perfusion/ventilation.
METHODS:
Sprague-Dawley rat heart-lung grafts were isolated and flushed with Krebs-Henseleit Buffer with 5% dextran 40 solution. The isolated grafts were mounted in an organ chamber, perfused with a medium of Lifor containing hydrocortisone, and ventilated with 95%O2/5%CO2 under 37º for 2 hours. Left lungs were orthotopically transplanted into age matched SD recipients. Lungs transplanted after 2 hours static cold preservation served as controls (n=5 per group). Right lungs were evaluated by histology, TUNEL staining, and infusion staining with fluorescent-labelled dextran and lectin. Transplant recipients underwent systemic arterial blood gases (PaO2) sampling after 24 hours and transplanted lungs were analyzed for wet/dry (W/D) weight ratio and morphologic features of graft dysfunction.
RESULTS:
No significant difference of apoptotic changes and microvascular leakage were observed between both groups. All transplanted cases survived, and PaO2, W/D ratio, and alveolar wall thickening were similar for both groups.
CONCLUSIONS:
NT lung perfusion/ventilation for 2 hours achieves equivalent results of lung transplantation when compared to standard cold preservation. This study establishes a reproducible small animal model to allow for systematic evaluation of NT lung preservation.
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