Release date: 2009-02-20
In an effort to maximize the use of donor organs, Chinese researchers conducted a study exploring the possibility of transplanting a single donor’s heart and lungs to multiple recipients. The team successfully retrieved three hearts and two lungs using in situ lavage and one-piece excision techniques, which were then transplanted into six patients—three with end-stage heart disease and three with end-stage lung disease. The process began by ventilating the donor, followed by opening the thoracic artery. Perfusion tubes were inserted into the aorta and pulmonary artery, with HTK solution used for heart perfusion and a modified raffinose low-potassium dextran solution for lung lavage. The heart and lungs were then removed as a single unit.
Before surgery, the recipients underwent retrograde lavage of the heart and lungs via the superior and inferior pulmonary veins or through the aortic root and vena cava sinus. For unilateral lung transplants, the donor lungs were separated into left and right. Among the three lung recipients, one received a left lung transplant, while two underwent sequential double-lung transplants without the need for cardiopulmonary bypass. The three heart recipients each had orthotopic heart transplants with double-venous anastomosis.
The outcomes showed that one patient who received a left lung transplant recovered well. Another patient who had a double lung transplant experienced a right upper lobe vein embolism and required reoperation on the ninth day, after which the affected lobe was removed and the patient was discharged. A third lung recipient developed bronchial anastomotic stenosis and pneumonia post-surgery, but recovered after treatment and was eventually discharged. Unfortunately, this patient later died from a severe infection seven months after the operation. One heart transplant recipient suffered from early renal failure, which was managed through hemodialysis before discharge. All three heart transplant patients experienced improved quality of life, with their heart function returning to class I.
This study demonstrates that it is both feasible and effective to allocate a single donor’s heart and lungs to different recipients, thereby maximizing the utilization of limited organ resources. ——Midi Medical Network
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