We have performed 28 single lung transplantation in mongrel dogs transplanting the left lung exclusively from November 1989 to September 1991, in the department of thoracic surgery of Seoul National University Hospital.
In the donor dogs, the main pulmonary artery was divided proximal to its bifurcation, and the left atrium was incised freeing the left veins with a generous atrial cuff. We used cold saline in the first 7 transplantations and Euro-Collins or
modified
Euro-Collins solution in the remaining 17 transplantations as a lung preservatives.
The bronchus was divided at two cartilage rings proximal to the upper lobe bronchus take off.
In the recipient procedure, we used a Fogarty catheter as a bronchus block. Left atrial anastomosis was performed first using 5-0 prolene and the pulmonary artery was anastomosed using 6-0 prolene.
The bronchus was anastomosed nest with 4-0 vicryl interruptedly and covered with a greater omentum which had been prepared previously.
All dogs received cyclosporin A and azathioprine as immunosuppressants and were divided into two group.
In the 10 Group I dogs, they survived within 6 days, mean survival time was 66.8±53.4 hours.
In remainder 14 Group II dogs, they survived above 6 days, mean survival time was 9.5±5.6days.
The cause of death were as follows : 2 cases of sacrifice, 2 cases of respiratory insufficiency during operation, 2 case of arrhythmia immediate postoperatively, 2 cases of bleeding, others in Group I, and 6 cases of sacrifice 4 cases of sepsis,
3
cases
of bleeding, others in Group II.
Results of bronchoscopic findings were obstruction above 50% in 12 cases of 16 performance cases within 5th day.
Early chest radiologic haziness were showed, and total lung perfusion defect was frequently showed in both group within 7th day. Main autopsy findings were left atrial and pulmonary arterial thrombi and bronchial obstruction
The major histologic findings of Group I were pleural exudate, hemorrhagic infarct, pulmonary congestion, and interesting histologic findings of Group II were 3 cases of perivascular or peribronchial lymphocyte infiltration, 3 cases of hemorrhage
infarct, 2 cases of interstitial pneumonitis. The structual change of bronchioles, suggesting bronchiolitis obliterstitial was not observed due to improper preparation of proximal pulmonary tissue and short term survival times.
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