Pulmonary mechanics after cardio‐pulmonary transplantation, an experimental study

An experimental model was developed in pigs (weight: 25 ± 2 kg), to evaluate pulmonary mechanics during the first 2 h of reperfusion following heart‐lung transplantation. We studied two groups with three transplantations each: group A (45 min of preservation) and group B (6 h of preservation). After rinsing out the heart‐lung mass by the injection of a cold intracellular solution (K+ = 115 mEq/l) into the aorta and the pulmonary artery, the organs were removed and conserved in a cold environment (0.5 °C). The orthotopic heart‐lung transplantation was carried out using extra‐corporeal circulation. Pulmonary mechanics were evaluated before and after transplantation by measuring the pulmonary compliance (C), and the aero‐dynamic resistance (R) with an interrupted air flow technique. Cardiorespiratory assistance Group A Group B C: 1 h of reperfusion − 17.2% ± 7.04 − 20.8% ± 12.4 C: 2 h of reperfusion − 30.3% ± 4.6 − 32.2% ± 2.6 R:1 h of reperfusion + 130.8% ± 116.9 + 301.5% ± 60.7 R: 2 h of reperfusion + 193.7% ± 80 + 372.5% ± 190.7 The duration of ischaemia appeared to be a pernicious factor in cardiopulmonary function. In all cases, the protection protocol of the heart‐lung block had allowed a cutting‐off of the cardiorespiratory assistance. However, there were major pulmonary mechanical perturbations, associated with a reduction in the pulmonary compliance and a very important increase in the aerodynamic resistance.