INTRATHORACIC COOLING OF CADAVERS BEFORE LUNG TRANSPLANTATION USING COLD AIR

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Abstract
In an attempt to identify an effective method of harvesting adequately functioning donor lungs from a cadaver, we devised an intrathoracic cooling method utilizing cold air that resulted in successful experimental lung transplantation. The lungs of donor mongrel dogs were inflated with 100% oxygen after death. The animals in group I (n=5) were left at room temperature for 2 hr, whereas those in group II (n=5) were left for 2 hr with their left thoraces filled with cold air cooled by dry ice. The lungs were subsequently flushed with cold Euro-Collins solution, harvested, and stored inflated in a cold saline solution for a further 2 hr. Left lung allotransplantation was then performed. Transplanted left lung function was examined by inducing occlusion of the native right bronchus and pulmonary artery for 10 min while the left lung was ventilated with 100% oxygen. There was a slow decline in intrathoracic, lung surface, and endobronchial temperatures toward room temperature in group I. In contrast, all three temperatures dropped to approximately 10 degrees C within 30 min in group II. In group I, all recipient dogs died immediately after occlusion was induced, whereas four of the five dogs in group II survived to show satisfactory lung function. (1) Intrathoracic topical cooling of a cadaver by cold air is efficacious in decreasing lung temperature and thus preserving lung tissue function. (2) Transplantation of cadaver lungs harvested using this novel method might be clinically feasible.