IL TRAPIANTO MONOPOLMONARE SPERIMENTALE. VALUTAZIONE FUNZIONALE E RIVASCOLARIZZAZIONE BRONCHIALE

Purpose of this paper is to evaluate the role of bronchial revascularization in preventing bronchial haeling defects in experimental lung ktransplantation. Thirtythree pigs (20-40 kg) underwent left lung allotransplant. In 24 the aortic patch with donor left bronchial artery was prepared and anastomized to the recipient descending aorta. Separate native and transplanted lung functional evaluation was carried out by gasanalisis of blood from right and left pulmonary veins selectively sampled by means of two silicon catheters connected to subcutaneous reservoirs. Eight animals were put to death at 11-15 postoperative day; five animals died earlier (2 to 9 postop day); the other animals died intraoperatively or whitin few hours. In all animals it was possible to easily prepare a viable aortic patch with the left bronchial artery, as proved by contrast or dye injection. Of 8 survivors, 5 developed massive graft hepatization, with thrombosis of pulmonary artery and veins. Full thickness bronchial necrosis of the transplanted lung was also present. Whether this is the result of rejection, infection or poor graft preservation was unclear. Other survivors showed healed bronchial anastomosis with normal epithelial lining. Aortic patch contrast injection showed a full patency of the bronchial circulation in these cases. Functional evaluation showed lower level of PO₂ in graft than native lung both at the end of transplant and at 15th day evaluation.