Optimal time for post-mortem heparinization in canine lung transplantation with non-heart-beating donors.

Abstract

BACKGROUND:

We previously reported that post-mortem heparinization by closed-chest cardiac massage is beneficial in lung transplantation from non-heart-beating donors by preventing formation of microthrombi. In this study, we evaluated the optimal time for post-mortem heparinization in canine lung transplantation from non-heart-beating donors.

METHODS:

Left lung transplantation was performed in 25 weight-matched pairs of mongrel dogs. Donors were killed with an intravenous injection of potassium chloride and left at room temperature for 2 hours. The cadaver donors were assigned randomly to one of five study groups. In Group H0, heparin sodium (1,000 U/kg) was given intravenously before cardiac arrest. In Groups H10, H30, H45 and H60, heparin sodium (1,000 U/kg) was given intravenously 10, 30, 45 and 60 minutes after cardiac arrest, respectively, followed by closed-chest cardiac massage for 2 minutes. After 2 hours of cardiac arrest, donor lungs were flushed with low-potassium dextran glucose solution and preserved for 60 minutes. After left lung allotransplantation, the right pulmonary artery was ligated, and recipient animals were followed up for 3 hours. Uni- and multivariate repeat analyses were utilized for statistical assessment.

RESULTS:

After transplantation, gas exchange was significantly worse in Groups H45 and H60 than in Groups H0, H10 and H30. Thrombin/anti-thrombin III complex concentration during warm ischemia was significantly higher in Groups H30, H45 and H60 than in Groups H0 and H10.

CONCLUSIONS:

The optimal time for post-mortem heparinization in lung transplantation from non-heart-beating donors is approximately 30 minutes after cardiac arrest.

• Authors: Mikio Okazaki, Hiroshi Date, Hidetoshi Inokawa, Daisuke Okutani, Keiju Aokage, Itaru Nagahiro, Motoi Aoe, Yoshifumi Sano, Nobuyoshi Shimizu
• Journal: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation (J Heart Lung Transplant) Vol. 25 Issue 4 Pg. 454-60 (Apr 2006) ISSN: 1557-3117 [Electronic] United States
• PMID: 16563977 (Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anticoagulants
• Heparin

Topics

• Animals
• Anticoagulants (therapeutic use)
• Dogs
• Heart Arrest, Induced (adverse effects)
• Heparin (therapeutic use)
• Lung Transplantation
• Organ Preservation (methods)
• Respiratory Function Tests
• Thrombosis (etiology, pathology, prevention & control)
• Time Factors
• Tissue Donors