Hidetoshi Inokawa, MD, PhD, Mayura Sevala, PhD, William K

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Ex-Vivo Perfusion and Ventilation of Rat Lungs From Non-Heart-Beating Donors Before Transplant Hidetoshi Inokawa, MD, PhD, Mayura Sevala, PhD, William K. Funkhouser, MD, PhD, Thomas M. Egan, MD, MS The Annals of Thoracic Surgery Volume 82, Issue 4, Pages 1219-1225 (October 2006) DOI: 10.1016/j.athoracsur.2006.05.004 Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 The ex-vivo rat lung perfusion and ventilation circuit. The rat heart–lung block is suspended from a Grass force-weight transducer. Perfusate is circulated through a water-jacketed venous reservoir that contains a thermometer and a pH probe. The temperature of the water bathing the reservoir is controlled by positioning a separate pump in one of two coolers, one at 37°C and the other containing ice water. Pressure transducers continuously record pulmonary artery (PAP), pulmonary vein (PVP), and airway (AWP) pressures. The Annals of Thoracic Surgery 2006 82, 1219-1225DOI: (10.1016/j.athoracsur.2006.05.004) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Partial pressure of oxygen (Po2) in mm Hg from the left pulmonary vein (PV) and left ventricle (LV) 1 hour after left lung transplantation, just before sacrifice. Results expressed as mean ± SEM. (HBD = heart-beating donor; NHBD = non-heart-beating donor; crys = crystalloid solution.) The Annals of Thoracic Surgery 2006 82, 1219-1225DOI: (10.1016/j.athoracsur.2006.05.004) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Wet/dry (W/D) weight ratio of lungs 1 hour after transplant. Data shown as mean ± SEM. (R = unused donor right lung; L = transplanted left lung; HBD = heart-beating donor; NHBD = non-heart-beating donor; crys = crystalloid solution.) *p < 0.05 compared with HBD or NHBD. The Annals of Thoracic Surgery 2006 82, 1219-1225DOI: (10.1016/j.athoracsur.2006.05.004) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Myeloperoxidase (MPO) and conjugated dienes (CD) from transplanted left lungs after sacrifice 1 hour after reperfusion. Data are mean ± SEM. (HBD = heart-beating donor; NHBD = non-heart-beating donor; crys = crystalloid solution.) #p < 0.05 for HBD compared with all other groups; *p < 0.05 for NHBD compared with HBD. The Annals of Thoracic Surgery 2006 82, 1219-1225DOI: (10.1016/j.athoracsur.2006.05.004) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Representative sections from the four groups. Perivascular and peribronchial edema (e) was present in all transplanted lung specimens. Alveolar capillary vascular congestion was apparent only in lungs that had been perfused in the ex-vivo circuit. Original magnification ×200, hematoxylin and eosin stain. (HBD = heart-beating donor; NHBD = non-heart-beating donor; crys = crystalloid solution.) The Annals of Thoracic Surgery 2006 82, 1219-1225DOI: (10.1016/j.athoracsur.2006.05.004) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions