Partial liquid ventilation with perfluorodecalin following unilateral canine lung allotransplantation in non–heart-heating donors

Abstract

Background The purpose of this study was to evaluate canine lungs obtained from non–heart-beating donors after unilateral lung transplantation subjected to partial liquid ventilation with perfluorodecalin. Methods Twelve donor dogs were killed and kept under mechanical ventilation for 3 hours. Heart–lung blocs were harvested after retrograde pulmonary hypothermic flush with Perfadex. Left lung grafts were randomly transplanted into 12 weight-matched recipient animals. Animals were divided into 2 groups: control (standard mechanical ventilation, n = 6) and PLV (partial liquid ventilation, n = 6). Forty-five minutes after transplantation, the animals in the PLV group received perfluorodecalin (15 ml/kg) via orotracheal tube. All animals received volume-controlled ventilation (F io 2 1.0, PEEP 5 cm H 2O) over 6 consecutive hours. Thereafter, blood-gas analysis, ventilatory mechanics and hemodynamics were registered at 30-minute intervals. After 6 hours of reperfusion the animals were killed and the transplanted lungs were extracted to obtain the wet/dry weight ratio. Results There were significant differences in pulmonary arterial pressure, which were higher in control group animals ( p < 0.009). The control animals also showed higher arterial Pa o 2 than those in the PLV group ( p < 0.00001), but lower Pa co 2 ( p < 0.008). The peak and plateau pressures were higher in the PLV group ( p < 0.00001). Neither static compliance nor wet/dry weight ratios were different in between groups. Conclusions PLV with perfluorodecalin yields functional results compatible with life in this model. Nonetheless, pulmonary gas exchange and mechanics were superior after reperfusion in animals given conventional mechanical ventilation up to 6 hours after left lung allotransplantation.