M. Okada et al., SINGLE-LUNG TRANSPLANTATION FOR CANINE PULMONARY-HYPERTENSION, The Journal of heart and lung transplantation, 16(5), 1997, pp. 532-537
Citations number
16
Categorie Soggetti
Cardiac & Cardiovascular System",Transplantation,"Respiratory System
Background: In spite of recent reports of the clinical application of
single lung transplantation for pulmonary hypertension, there is littl
e underlying experimental data because of the lack of a reliable anima
l pulmonary hypertensive transplant model. We have established a pulmo
nary hypertensive model in beagles with dehydromonocrotaline and have
been able to measure cardiopulmonary hemodynamics accurately and use c
irculatory assists during procedures. The purpose of this study was to
determine whether single lung transplantation could be performed afte
r the protocol of clinical procedure. Methods and Results: In six cont
rol dogs, allografting was successfully completed without cardiopulmon
ary bypass. Because one pulmonary hypertensive recipient dog died of r
ight ventricular failure during the procedure without cardiopulmonary
bypass, we used bypass for allografting in five pulmonary hypertensive
dogs. Cardiopulmonary bypass lowered pulmonary artery pressure, allow
ing pulmonary arterial clamping and avoiding right ventricular overloa
d. All pulmonary hypertensive dogs undergoing bypass were successfully
weaned from bypass, indicating a good hemodynamic response to transpl
antation. In pulmonary hypertensive dogs, transplantation resulted in
significant decreases in systolic pulmonary artery pressure and pulmon
ary vascular resistance, and a significant increase in blood flow to t
he graft lung, whereas in controls the results were the reverse. Concl
usions: Thus we were able to show that hemodynamics improved after sin
gle lung transplantation with cardiopulmonary bypass in a new pulmonar
y hypertensive animal model. These relatively larger animals are valua
ble for further studies of single, double, bilateral, and heart-lung t
ransplantation for pulmonary hypertension.