Tóm tắt

Objectives: This study describes some new anatomical findings of the right accessory lobe and a new experimental porcine lung transplant model and our experience with surgical training for the first clinical lung transplant of Vietnam. Subjects and methods: 20 pigs were used for anatomical study. Heart - lung blocks were removed. Methylene blue was selectively injected to different branches of pulmonary artery. Then, all heart - lung blocks were carefully dissected. 30 pigs were used to invent a new surgical model. The caudal lobes of the right lungs were harvested from 15 deceased donors, then transplanted into the opposite position as left caudal lobes (having been rotated 180° along the vertical axis) of 15 recipients following left pneumonectomy. Graft function was determined for 3 hours after reperfusion. Results: Only 13/20 cases, the right accessory lobe veins enter the root of the right caudal lobe veins as described by other authors, 3/20 enter the right inferior pulmonary veins, 2/20 enter the position between the right and the left inferior pulmonary veins, 2/20 enter the left inferior pulmonary veins. Porcine living donor using right lung is impossible, using left lung is possible, but different strategies must be used to preserve the blood supply to the donor’s right accessory lobe. With deceased donor, both the right and left caudal lobes could be used, the right accessory lobes should be excluded. In new surgical model study, all 15 recipients survived, all grafts showed excellent acute and long-term function. Conclusion: A new porcine lobar lung transplant from deceased donor has been invented. This model could be used easily for all anatomical variants. * Keywords: Experimental lung transplant; Anatomy characteristics.

Abstract

Objectives: This study describes some new anatomical findings of the right accessory lobe and a new experimental porcine lung transplant model and our experience with surgical training for the first clinical lung transplant of Vietnam. Subjects and methods: 20 pigs were used for anatomical study. Heart - lung blocks were removed. Methylene blue was selectively injected to different branches of pulmonary artery. Then, all heart - lung blocks were carefully dissected. 30 pigs were used to invent a new surgical model. The caudal lobes of the right lungs were harvested from 15 deceased donors, then transplanted into the opposite position as left caudal lobes (having been rotated 180° along the vertical axis) of 15 recipients following left pneumonectomy. Graft function was determined for 3 hours after reperfusion. Results: Only 13/20 cases, the right accessory lobe veins enter the root of the right caudal lobe veins as described by other authors, 3/20 enter the right inferior pulmonary veins, 2/20 enter the position between the right and the left inferior pulmonary veins, 2/20 enter the left inferior pulmonary veins. Porcine living donor using right lung is impossible, using left lung is possible, but different strategies must be used to preserve the blood supply to the donor’s right accessory lobe. With deceased donor, both the right and left caudal lobes could be used, the right accessory lobes should be excluded. In new surgical model study, all 15 recipients survived, all grafts showed excellent acute and long-term function. Conclusion: A new porcine lobar lung transplant from deceased donor has been invented. This model could be used easily for all anatomical variants. * Keywords: Experimental lung transplant; Anatomy characteristics.