| Lung transplantation has already become the preferred treatment option for a variety of end-stage pulmonary diseases. Up to now, dozens of lung transplants have been performed in our country, but Long-term survival rate is low. Current situation of domestic lung transplantation's development is lagging behind relatively. To establish successful models of transplantation is the preliminary preparation for lung transplantation, therefore we carried out an experimental study on canine lung transplantation successfully (April 2003-April 2004). Objective: To grasp basic steps and main points of lung transplantation by performing single lung transplantation of left lung on dog, discuss the experience and lessons about success and failure, and lays the foundation for human lung transplantation.Methods: Sixteen hybrid dogs which weigh between 20-25kg were divided into eight pairs randomly. In each pair, one was used for donor and another for recipient. Totally eight times of left lung transplantation were performed.Results: Among 8 dogs as receptors in the experiment, 7 survived for 1-22h and one died during the operation. The 1st dog survived for 22 hours and the reason for death is that liver entered the thorax through diaphragmatic hernia; The 2nd dog survived for 1h and thrombus formed in left pulmonary vein and left atrium cause extravasated blood and pulmonary edema, which leaded to the death; The 3rd dog survived for 3h and the 5th dog survived for 4h, formed thrombus could been found in left pulmonary artery anastomosis and main pulmonary artery, which caused right heart failure and leaded to the death; The 4th dog survived for 8h and the 7th dog survived for 12h, the autopsy showed no abnormal feathers and we considered that circulation failure and arrhythmia were the major reasons for death. The 6th dog survived for 20h, the autopsy showed no abnormal at vessel anastomosis, but we found extravasated blood in the lung on both sides and the trachea is filled with bloody phlegm, acute left heart failure and respiration failure were considered to be the major reasons for death; Trachea cannula sliped off accidentally during the operation performed on the 8th dog, then heart arrest appeared, breathing and heartbeat resumed after CPR, after another 1h,s operation heart arrest appeared again and the dog died with CPR expiration.There is our experience as following: 1.Try to shorten the time spent on the donor lung's transplanting into the recipient; 2. Donor lung's anastomosis could adopt the sequence of bronchus first, pulmonary artery, left atrium. Anastomosing the bronchus at first could play a role of fixation and make other anastomosis easier and convenient; 3.When cliping the donor's pulmonary vein, we should leave more circumambient atrium in order to shape bigger atrium sleeve, which could avoid the narrow of the anastomosis after the operation efficiently. During the operation of lung resection we should try to reserve the trunk of pulmonary artery to facilitate the anastomosis and should pay attention to the matching of pulmonary artery's caliber;4. The bronchus' anastomosis may be performed by a sheathing method. When performing the resection of donor's lung tissue, we should try to reserving the tissue around the bronchus and resect the boronchus near to the carina as possible in order to guarantee the blood's supply; 5.During the operation we must assure the fixation of the trachea cannula to guarantee constant oxygen supply. 6.In the experiment, we should pay more attention to maintain the function of heart and lung during the operation and postoperation and administrate medicine timely to reduce the death rate; 6. Strict examination is essential before closing the thorax. During the operation we should avoid any simultaneous injury to surrounding tissue or organs such as diaphragmatic trauma. Any unnoticed mistake will lead to the failure of the whole work.The lung transplantation operation is a highly difficult big-organ transplant operation. To the personn...
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