NIMAN, Eito

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Okayama University Scientific Achievement Repository

3  Abstract 30 Backgrounds: Brain-dead donors are susceptible to pulmonary atelectasis (AT). In procurement surgery, lung 31 recruitment under circulatory conditions and cold-flushing for atelectatic donor lungs often provoke graft injury 32 due to the acute blood inflow. We hypothesized that lung recruitment without blood circulation can mitigate graft 33 injury. This study aimed to examine the benefits of lung recruitment subsequent to cardiac arrest using a porcine 34 lung-transplant model. 35 Methods: Thirteen donor pigs were categorized into the non-atelectatic (No-AT) group (n=3) representing a 36 healthy control group; AT-BCR group (n=5), in which AT was reverted by conventional blood-circulated-37 recruitment (BCR); and AT-no-BCR group (n=5), in which AT was reverted by no-BCR following circulatory 38 arrest. In the atelectatic donor models, the left main bronchus was ligated for 24 hours prior to lung procurement. 39 Left lung transplantation was subsequently performed in the thirteen recipient pigs. After 6 hours evaluation, the 40 recipients were euthanized and the lung grafts were excised. 41 Results: The post-transplant PaO2/FiO2 ratio was significantly higher in the AT-no-BCR group than in the AT-42 BCR group (p=0.015). Wet/dry ratio, histological findings of graft injury and tissue interleukin-8 expression in 43 the AT-no-BCR group were similar to those of the No-AT group. 44 Conclusions: Lung recruitment without circulation after circulatory arrest could be more protective for atelectatic 45 donor lung than the conventional procedure. 46 Key words: lung transplantation, lung recruitment maneuver, atelectasis, protective procurement  47 

肺移植における無気肺ドナーからの臓器保護的肺摘出法

https://ousar.lib.okayama-u.ac.jp/files/public/6/65308/20230606172103565945/K0006747_summary.pdf

肺移植における無気肺ドナーからの臓器保護的肺摘出法

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