Experimental Transplantation of Left Lung in Dogs

Four single transplantations of left lungs in dogs were performed from October 1989 to June 1990 at the department of Thoracic and Cardiovascular surgery, Collge of Medicine, Ewha Womans University.Under general endotracheal anesthesia, the donor dog was placed in right lateral decubitus position and the left anterolateral thoracotomy incision was made. Both lungs and heart were removed by division of superior vena cava, inferior vena cava, descending aorta and trachea. After trimming, left lung was immersed in a basin containing 4℃ normal saline and the pulmonary artery was flushed by the dripping of the heparinized cold saline with 60cm H2O pressure.In the recipient dog, left extrapericardial pneumonectomy was done as in usual manner. Prepared left lung of donor dog was placed in the left thoracic cavity of the recipient dog and pulmonary arterial anastomosis was made with continuous 5-0 Prolene** suture. Recipient's pericardium was opened and anastomosis of the left atrial cuff was performed with continuous 3-0 Prolene suture. Air was evacuated from the left atrium by gradual release of left atrial clamp and inducing the back bleeding before completion of anastomosis.Bronchial anastomosis was performed with interrupted 4-0 absorbable suture and knots were placed externally.Throught upper mid-laporotomy incision, omentum was mobilized and retrieved through created retrosternal tunnel and anastomosised mainstem bronchus was completely wrapped.After operations, 3 dogs died due to hemorrhagic shock, asphyxia and stenosis of left pulomnary artery at the anastomosis site. One had survived to postoperative 7th day in good condition.