Ja. Kern et al., ANALYSIS OF AIRWAY FUNCTION OF IMMATURE WHOLE LUNG TRANSPLANTS VERSUSMATURE LOBAR TRANSPLANTS, The Annals of thoracic surgery, 57(5), 1994, pp. 1089-1094
For the pediatric patient with end-stage lung disease in need of trans
plantation, two potential donor options currently exist: size-matched
immature whole lungs or reduced-size mature lobes. To determine which
of these options provides superior long-term function, we studied airw
ay mechanics in a chronic porcine model of pediatric lung transplantat
ion. Three groups of animals were studied: the first group underwent l
eft upper lobectomy at 9 +/- 1 weeks of age (innervated left lower lob
es). These animals served as controls. A second group of 9-week-old an
imals received an immature whole left lung allograft from age-matched
donors. The third group received a reduced-size mature left lower lobe
from 6-month-old donors. Measurements of dynamic airway resistance, p
ulmonary compliance, and functional residual capacity of the isolated
lobes or lungs, and of the nonoperated right lungs, were recorded 12 /- 1 weeks later, and mean values were calculated for each group. Resu
lts showed that transplantation of an immature whole lung resulted in
abnormal dynamic airway resistance to airflow, which was not seen in t
he mature lobar transplants. In addition, compliance was impaired most
significantly in the immature whole lung transplants. We conclude tha
t in this experimental model of pediatric lung transplantation, transp
lantation of a mature lobar segment results in superior long-term airw
ay function when compared with immature whole lung transplants.