In order to establish more simple and effective rat orthotopic lung transplantation models, 20 rats were divided into donor and recipient groups. Rat lung transplantation models were established by using improved cuff technique. All the 10 operations were accomplished successfully. The mean operative time of recipients was 45 +/- 4 min. The survival time was over 30 days after lung transplantation. The checks of X-ray were almost normal. There was no significant difference in the blood gas analysis before and after clipping the right hilum (P > .05). This method is more simple, applicable and requires less time.
*Lung Transplantation/methods ; Models, Animal ; Rats, Sprague-Dawley

Child ; China ; Humans ; Living Donors ; Lung Injury ; therapy ; Lung Transplantation ; methods ; Male

Herein, we report a case of lung transplantation in a patient with profound preoperative hypercapnia, focusing on the cardiopulmonary bypass strategy used for brain perfusion during the operation. We applied the pH-stat method for acid-base regulation, and thereby achieved the desired outcome without any neurologic deficit.
Brain ; Cardiopulmonary Bypass ; Cerebrovascular Circulation ; Humans ; Hypercapnia ; Lung Transplantation ; Lung ; Methods ; Neurologic Manifestations ; Perfusion

OBJECTIVETo explore the feasibility and efficiency of lung transplantation in the treatment of bronchiolitis obliterans (BO) after allogeneic bone marrow transplantation (allo-BMT).

METHODSWe reported one case of bilateral lung transplantation for BO after allo-BMT and reviewed the related literatures.

RESULTSA 23 year-old man diagnosed as BO after allo-BMT underwent a sequential bilateral lung transplantation through bilateral anterolateral thoracotomy without sternal division. The patient suffered from acute rejection on post-operation day (POD) 2, and cured by mechanical ventilation, large dose of methylprednisolone and gamma globulin. The patient was transferred out of the intensive care unit on POD 14 and discharged from the hospital on POD 43. Chest CT scans and pulmonary function tests showed good performance in 3 and 6 months follow-up period.

CONCLUSIONBO is one of the late common non-infectious pulmonary complication after allo-BMT. For patients who have no response to medication, lung transplantation is the only efficient treatment choice so far, which can prolong survival and improve the quality of life. However, limited by small samples, optimal surgery time and appropriate care of postoperative complications still need accumulation of experience by multicenter and large samples studies.

Bone Marrow Transplantation ; adverse effects ; Bronchiolitis Obliterans ; etiology ; surgery ; Humans ; Lung Transplantation ; methods ; Male ; Transplantation, Homologous ; Young Adult

Animals ; Cell Culture Techniques ; Humans ; Lung ; cytology ; Regenerative Medicine ; methods ; Stem Cell Transplantation ; methods

OBJECTIVE: To investigate the methods to alleviate lung injury of non-heart-beating donor to attain better structure and function. METHODS: Sixty-four Sprague-Dawley rats were randomly divided into 4 groupsú a heart-beating donor group(HBD group), a non-heart-beating donor group without protective measures(NHBD-N group), a non-heart-beating donor group with continuous mechanical ventilation or with topical cooling on cadaver lung (NHBD-V group and NHBD-I group). After the transplantation, lung compliance,pulmonary function,wet/dry ratio of lung and content of energy metabolism were compared among the 4 groups. RESULTS: Due to the longer warm ischemic period, NHBD lungs suffered more injuries than HBD lungs. However, compared with NHBD-N group, the wet/dry ratio of the lung in NHBD-V group and NHBD-I group was lower(5.28+/-1.24,4.21+/-0.85,4.14+/-1.33,P<0.01),the lung injury index (14.35+/-3.21,11.28+/-3.26,10.41+/-2.85, P<0.01)and the count of white blood cells(425.60+/-86.47,316.30+/-56.24,295.50+/-70.26, P<0.01) were milder, while the lung compliance and preservation of energetic metabolte were better in the NHBD-V group and the NHBD-I group. CONCLUSION Continuous mechanical ventilation or topical cooling may protect the NHBD lung during the warm ischemic period.
Animals ; Cadaver ; Heart Arrest ; metabolism ; physiopathology ; Lung ; metabolism ; physiopathology ; Lung Compliance ; Lung Transplantation ; methods ; Male ; Organ Preservation ; methods ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Time Factors ; Tissue Donors

OBJECTIVEThe aim of this study was to establish patient-derived lung cancer xenograft models in nude mice by subcutaneous and subrenal capsule transplantation, and to analyze the differences in biological characteristics of the xenografts.

METHODSSurgically resected lung cancer specimens from 11 patients were implanted subcutaneously and under the renal capsule in nude mice. The tumor growth and histopathological features were observed and human origin of the blood vessels in the first-generation xenograft tumors was evaluated by SP immunohistochemistry using anti-human CD31 antibody.

RESULTSThe patient-derived lung cancer tissues were successfully implanted subcutaneously and under the renal capsule in 11 nude mice. The operation time of subcutaneous implantation was 13 min, and the tumor formation rate was 36.4% (4/11). The operation time of implantation under the renal capsule was 45 min, and the tumor formation rate was 45.5% (5/11). Histopathological examination of the xenografts using HE staining showed the same morphology of the human lung cancers, and immunohistochemical observation with CD31staining showed that 83.3% (5/6) blood vessels in the xenograft tumors was of human origin.

CONCLUSIONSBoth methods of subcutaneous and subrenal capsule transplantation can be used to successfully establish patient-derived lung cancer xenograft models in nude mice. The subcutaneous implantation is simple to operate, less time-comsuming, and easy to observe the tumor growth, but with a lower success rate of tumor formation. Transplantation under the renal capsule has a higher tumor formation rate, but is more difficult to operate, taking more time, and difficult to observe the growth of the tumor. The xenograft tumors formed by both methods in the first generation display biological characteristics of human lung cancer, the xenograft tumor models are close to human lung cancer, and therefore may provide a stable, reliable, and useful animal model in human lung cancer research.

Animals ; Disease Models, Animal ; Heterografts ; Humans ; Immunohistochemistry ; Lung Neoplasms ; Mice ; Mice, Nude ; Neoplasm Transplantation ; methods ; Transplantation, Heterologous

OBJECTIVETo evaluate the effect of single lung transplantation with concomitant contralateral lung volume reduction surgery (LVRS) for the management of end-stage emphysema.

METHODSA 46 year-old patient with end-stage emphysema received right lung transplantation and LVRS through the bilateral anterior-lateral intercostal incisions simultaneously.

RESULTSHyperinflation of the native lung or mediastinal shift did not occur after the operation, and the transplanted right lung dilated well without suppression. Acute rejection was not observed and the patient weaned from tracheal intubation 60 h after operation and from ventilator 108 h postoperatively. Persistent air leak occurred after LVRS but closed after instillation of hyperosmotic glucose. The patient was discharged 45 days after operation with significantly improved pulmonary function and normal life.

CONCLUSIONSingle lung transplantation with concomitant contralateral lung volume reduction for emphysema eliminates such complications of single lung transplantation as native lung hyperinflation, mediastinal shift, excessive suppression of the transplanted lung and hemodynamics instability, and can improve the success rate of the operation.

Combined Modality Therapy ; Humans ; Lung ; pathology ; surgery ; Lung Transplantation ; methods ; Male ; Middle Aged ; Pulmonary Emphysema ; pathology ; surgery ; Treatment Outcome

OBJECTIVETo review the experience with the management of single lung transplantation for emphysema.

METHODSBetween January 2003 and August 2006, single lung transplantation was performed in 6 patients for emphysema with cold low potassium solution flushing. A triple-drug regimen was adopted using steroids, mycophenolate mofetil and tacrolimus as the maintenance immunosuppressants. Chest radiograph score, oxygenation index, and pulmonary arterial pressure of the patients in early after the transplantation were reviewed.

RESULTSAll the 6 patients survived for over 30 days after the operation, and 4 of them remained alive with good quality-of-life. Four patients recovered from acute rejection successfully after methylprednisolone pulse therapy for 3 days. One patient underwent reoperation for hemorrhage in the thoracic cavity and finally recovered; spontaneous pneumothorax of the autologous lungs occurred in two patients, who underwent reoperation but finally died 74 days and 77 days after the transplantation, respectively.

CONCLUSIONSingle lung transplantation is effective for end-stage emphysema. Carefully selected recipients and comprehensive design of the surgical procedures are critical to successful lung transplantation.

Adult ; Female ; Humans ; Lung Transplantation ; methods ; Middle Aged ; Pulmonary Emphysema ; surgery ; Treatment Outcome

OBJECTIVETo evaluate operative technique, patient selection and perioperative management of single-lung transplantation for a patients with end-stage emphysema.

METHODSA 56-year-old patient with end-stage emphysema underwent left-lung transplantation on September 28, 2002. The surgical technique used was similar to that mentioned in the literature. The donor lung was perfused by LPD solution with a cold ischemic time of 260 minutes. Cardiopulmonary bypass was not performed.

RESULTSThe patient weaned from a ventilator at the 93th hour after operation. Immunosuppressants included cyclosporine, mycophenolate mofetil and corticosteroid. Acute rejection occurred on the ninth day after operation and was cured by bolus methylprednisolone given intravenously. Lung function was improved significantly and the patient was discharged from the hospital on the 47th day after operation.

CONCLUSIONSingle-lung transplantation for patients with end-stage emphysema is effective for long-term improvement of pulmonary function.

Adult ; Emphysema ; surgery ; Graft Rejection ; prevention & control ; Humans ; Lung Transplantation ; methods ; Male ; Middle Aged