The Journal of Thoracic and Cardiovascular Surgery, Vol 72, 97-105, Copyright © 1976 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Effective preservation and transportation of lung transplants
FJ Veith, R Crane, M Torres, I Colon, JW Hagstrom, K Pinsker and SK Koerner
To evaluate a system for preserving and transporting lungs before
transplantation, we removed the left lungs of 37 dogs, flushed them with a
hypertonic solution having an electrolyte composition resembling
intracellular fluid, and immersed them at 4 degrees C. for 7 to 24 hours.
Some lungs were maintained at exactly 4 degrees C. during transport by
means of a mixture of solid and liquid l-hexadecene. The lungs were
allografted into immunosuppressed dogs whose right pulmonary artery was
immediately ligated. Twelve recipients (32 per cent) survived 5 days or
more solely on the function of the preserved lung. Four survived 10, 19,
40, and 40 days with lungs that had been preserved for 7 to 21 hours.
Survival of recipients of preserved lungs (5 +/- 2 days) was equivalent to
that of 75 comparably immunosuppressed recipients of nonpreserved
allografts (6 +/- 1 days). One group of 10 dogs receiving lungs flushed
against outflow resistance survived 12 +/- 5 days. In recipients of
preserved allografts, arterial oxygen tensions remained in the normal range
up to 5 weeks after transplantation, and radiographic infiltrates in the
transplant were no greater than those present in recipients of nonpreserved
transplants. Thus lungs transported and preserved up to 21 hours can
provide total pulmonary function after transplantation and can function at
least as well as nonpreserved transplants. The effectiveness and simplicity
of this method are such that it might be considered for use in man.
