Transplantation of lungs from non-heart-beating donors after functional assessment ex vivo

Ann Thorac Surg. 2003 Jul;76(1):244-52; discussion 252. doi: 10.1016/s0003-4975(03)00191-7.


Background: If lungs from patients dying of heart attacks are to serve as donor organs in a safe way, their function should be properly assessed before transplantation. The aim of this study was to investigate donor lung function evaluation in a realistic large animal model.

Methods: Twelve 60-kg pigs were used. Five minutes after ventricular fibrillation was induced, cardiopulmonary resuscitation was initiated and maintained for 20 minutes. After a 10-min hands-off period, heparin was administered through a central venous catheter followed by 20 chest compressions. Intrapleural cooling was initiated after 65 minutes of warm ischemia. Cooling proceeded for 6 hours within the cadaver, after which lung function was assessed ex vivo. Recipient pigs underwent left lung transplantation followed by right pneumonectomy, thus making these animals 100% dependent for their survival on the function of the donor lungs.

Results: The assessment showed that all lungs had adequate function to serve as donor lungs. All recipient animals were in good condition during the 24-hour observation period after the operation. The blood gas function did not differ significantly from that in the healthy donor animals before induction of ventricular fibrillation; pulmonary vascular resistance was within normal range.

Conclusions: Lungs from non-heart-beating donors topically cooled in situ for 6 hours after 65 minutes of warm ischemia were assessed ex vivo and found to have normal function. They were then transplanted and retained normal function during a 24-hour observation period.

MeSH terms

  • Animals
  • Disease Models, Animal
  • Graft Rejection
  • Graft Survival
  • Hemodynamics / physiology
  • Lung Compliance
  • Lung Transplantation / methods*
  • Organ Preservation
  • Predictive Value of Tests
  • Pulmonary Gas Exchange
  • Respiratory Function Tests
  • Risk Assessment
  • Sensitivity and Specificity
  • Swine
  • Tissue Donors*
  • Transplantation, Homologous*