PULMONARY-FUNCTION AFTER NON-HEART-BEATING LUNG DONATION IN A SURVIVAL MODEL

Background. Lung procurement from recently deceased cadavers has been suggested to enlarge the limited donor pool. We hypothesized that lung s harvested from non-heart-beating donors (NHBD) would function as wel l as those harvested from heart-beating donors. Methods. Sixteen adult swine underwent left lung allotransplantation. Controls received lung s procured from heart-beating donors, NHBD pigs received lungs immedia tely harvested from donors after death from asphyxiation, and NHBD-15 and NHBD-30 pigs received lungs harvested after 15 and 30 minutes afte r asphyxiation. Results. After 1 week of survival, mean dynamic airway compliance (mL/cm H2O +/- standard error of the mean) was 16.3 +/- 0. 7 in controls, and 17.3 +/- 1.0, 16.4 +/- 6.0, and 7.3 +/- 1.6 in the NHBD, NHBD-15, and NHBD-30 groups, respectively (p = 0.02, NHBD-30 ver sus others combined). No significant differences were noted in the pul monary venous partial pressure of oxygen or pulmonary vascular hemodyn amics compared with controls. Conclusions. The decrease in airway comp liance noted in the NHBD-30 group may reflect an exacerbation of reper fusion injury caused by 30 minutes of warm ischemia during organ retri eval. We conclude that posttransplantation lung function using an NHBD with up to 15 minutes of warm ischemia is equivalent to lung function after heart-beating harvest.