Experimental study of mature pulmonary lobar allo-transplantation in puppies.

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Back ground : The use of reduced-size adult lung transplantation could help solve the profound pediatric donor lung shortage. However, adequate long-term function of mature grafts requires growth in proportion to the recipient's development. Methods : Six mature left lower lobes from adult beagles (mean body weight : 12kg) were harvested and transplanted to six immature beagles (age : 3 months, mean body weight : 5kg) that underwent left pneumonectmy (ID). The control group (MD) was 5 adult dogs that underwent mature pulmonary lobar allotransplantation. Right pulmonary arterial occlusion test was performed under mechanical ventilation with Fi02 1 in 12 months or more after transplantation. Cardiac output and pulmonary arterial pressure (PAP) were measured, femoral arterial blood gas analysis (PaOa and PaCOa) was performed, and AaDO2 was calculated before and after occlusion at 5, 10, 15, and 30 minutes. The grafts were removed and examined histologically. Results : In ID, five dogs survived and three dogs tolerated the right pulmonary arterial occlusion test. In MD, three dogs survived and tolerated the occlusion test. There was no significant difference in mean PAP elevation between ID and MD. There were no differences in changes in Pa02, PaCO2 and AaDO before and 30 minutes after occlusion. Histological studies showed normal architecture of lung parenchyma but alveolar enlargement was observed in both ID and MD grafts.Conclusion : We conclude that in this experimental model of mature lobar transplantation in puppies, the alveolar architecture of a mature lobe is almost normal appearance or emphysema, and the long term function of a mature lobe is maintained well.