versión On-line ISSN 1852-3862
INSAURRALDE, Diego et al. Experimental surgical praxis of lobar implant simulating living donor and/or pulmonary partition (split). Insuf. card. [online]. 2011, vol.6, n.1, pp. 8-18. ISSN 1852-3862.
Introduction. Lung transplantation is an alternative therapy that has been used since the early 1960s, initially with poor results. After the advent of cyclosporine in lung transplantation in the 80s, it began to emerge as a real alternative in some countries. The use of living donors for lung transplantation is conducting an alternative to the shortage cadaveric donors and high mortality in patients awaiting transplant list. Objectives. Acquiring skills (praxis) in the type of resection lobar reimplantation technique in living donor lobar postpneumonectomy hemithorax, reimplantation partition lobar pulmonary (lung split), postoperative evaluation, to achieve survival, study possible causes of death. Material and method. We used 18 dogs that underwent 24 surgeries. Three models of surgical technique were made: unilateral lobar autotransplantation; B, left lobar autotransplantation in right hemithorax (contralateral) after successive simultaneous pneumonectomy, and C, based on the model of the experiment previously performed (right hemithorax) split lung. Results. Surgery of type A: 16 all operated with survival after surgery, five died between 48 hours and 7 days after surgery. The dogs that survived the operation had conventional radiology. All booming revealed no residual pleural space. The wolf implanted with obvious signs of overreach by emphysema. The surviving animals (11) returned to their usual habitat. Surgery type B: two experiences that died in surgery of severe pulmonary hypertension. Surgical experience demonstrates that this technique is feasible for implementation, hemodynamic monitoring, with the aid cardiopulmonary bypass was not deliberately used in this experiment. Surgery type C: 3 dogs died in surgery for pulmonary hypertension incompatible. Two dogs died after 48 hours of respiratory failure and pulmonary hypertension possible. Conclusion. The experience related supports and encourages the organization of a clinical program to address these problems in lung transplant surgery in patients with small body surface and / or shortage of conventional donors.
Palabras clave : Lung transplantation; Living donor lobar transplant; Split; Surgical praxis.