[Method and technique of experimental autotransplantation of a lung and a lung lobe].
Perel'man Mi, Rabinowitsch Jj
Abstract
Perel'man Mi, Rabinowitsch Jj
Abstract
The authors have accumulated an experience of 350 canine autotransplantations of a lung and its lobe. The peculiarities of the operative technique are described, and special emphasis is laid on its technical details that largely determine the success of a lung autotransplantation. The described method and technique permit the performance of orthotopic autotransplantation of a whole lung and of its lobe, and of heterotopic autotransplantation of the lower lobe of the right lung into the left pleural cavity in place of a removed lower lobe or whole lung. The first stage of autotransplantation of a lung or its lobe consists in applying an atrio-venous or venous anastomosis and that of the pulmonary artery with continuous U-shaped eversion sutures, with a re-establishment of the circulation, thus reducing the period of lung ischaemia. Upon restoring the blood flow in the lung, a bronchial anastomosis is applied with interrupted or continuous sutures, and the ventilation is restored. The vascular and bronchial anastomoses are applied with synthetic suture material (Orsylon) on atraumatic needles. The extensive experience of the authors in long-term follow-up of the animals after transplantation (up to 5 years) demonstrates that the described technique and method of lung autotransplantation ensures good competence and patency of the vascular and bronchial anastomoses, without any stenoses observed in the late postoperative period. As shown by histological examinations, the inflammatory reaction around the suture material is minimal.
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The authors have accumulated an experience of 350 canine autotransplantations of a lung and its lobe. The peculiarities of the operative technique are described, and special emphasis is laid on its technical details that largely determine the success of a lung autotransplantation. The described method and technique permit the performance of orthotopic autotransplantation of a whole lung and of its lobe, and of heterotopic autotransplantation of the lower lobe of the right lung into the left pleural cavity in place of a removed lower lobe or whole lung. The first stage of autotransplantation of a lung or its lobe consists in applying an atrio-venous or venous anastomosis and that of the pulmonary artery with continuous U-shaped eversion sutures, with a re-establishment of the circulation, thus reducing the period of lung ischaemia. Upon restoring the blood flow in the lung, a bronchial anastomosis is applied with interrupted or continuous sutures, and the ventilation is restored. The vascular and bronchial anastomoses are applied with synthetic suture material (Orsylon) on atraumatic needles. The extensive experience of the authors in long-term follow-up of the animals after transplantation (up to 5 years) demonstrates that the described technique and method of lung autotransplantation ensures good competence and patency of the vascular and bronchial anastomoses, without any stenoses observed in the late postoperative period. As shown by histological examinations, the inflammatory reaction around the suture material is minimal.
Key concepts: Autotransplantation, Medicine, Anastomosis, Lung, Lung transplantation, Surgery, Transplantation, Fibrous joint