Extended Preservation of Ischemic Pulmonary Graft by Postmortem Alveolar Expansion

Pre-arrest Administration of the Cell-permeable Free Radical Scavenger Tempol Reduces Warm Ischemic Damage of Lung Function in Non–Heart-beating Donors

“…Van Raemdonck also suggested that the critical factor in protecting lungs from warm ischemia damage might be the prevention of alveolar collapse rather than the actual oxygen delivery caused by ventilation. 8 In contrast to our study and those of others, 4,18 Wittwer et al 17 found that ventilation in a pressurecontrolled mode with FIO 2 ϭ 0.5 for up to 300 minutes during warm ischemia had no harmful effect on pulmonary function. We have no explanation for this discrepancy.…”

“…All animals were then euthanized by overdose with sodium thiopental (250 mg/kg). 7,8 The animals were kept at room temperature for another 60 minutes (warm ischemia). During warm ischemia, animals in Group Av were ventilated (Model 683 Harvard Rodent Ventilator, Harvard Apparatus, Inc., Holliston, MA) with room air at 50 breaths/min, with peak inspiratory pressure 10 cm H 2 O, whereas rats from the other experimental group (Group An) were left untouched.…”

Overview of Clinical Lung Transplantation

“…A retrograde in situ lung flush is also performed with the same solution, again to improve the homogeneity of the flush (Varela et al 1997;Van De Wauwer et al 2009). The lungs are inflated with 50% oxygen before their removal from the body in order to maintain the delicate alveolar structure and to provide oxygen for metabolism (Van Raemdonck et al 1997). This is an important distinction of lung preservation as compared with other organ preservation in that the lung is stored in an aerobic hypothermic ischemic state so that aerobic metabolism can continue during the storage phase, albeit at a reduced rate.…”

Non–Heart-beating Lung Donation: How Big is the Pool?

“…This legal requirement follows the recommendations of the U.S. Institute of Medicine. 6 Based both on the experimental finding that, for an inflated lung, ischemia is not equal to hypoxia (making this type of lung less susceptible to warm ischemic damage) 7 and on the avoidance of classic brain-death injury to the lung, 8 we expected that NHB lungs would perform at least similarly compared with lung grafts from heart-beating donors. All reports on NHB lung donation have shown a good short-term function of the lungs, supporting the theoretical advantages.…”

“…All reports on NHB lung donation have shown a good short-term function of the lungs, supporting the theoretical advantages. 2,3,[7][8][9][10][11] In this study, a total of 8 bilateral lung transplantations from NHB III donors (median donor age 38 years) were performed at our center. At present, a total of 16 of these procedures have been performed.…”