Heparin does not seem to improve the function of pulmonary grafts for lung transplantation

Abstract

Background. It has been debated whether or not heparin infusion before or after non-heart-beating donors are declared dead improves the quality of pulmonary grafts. In clinical lung transplantation with heart-beating donors (HBDs) heparin is routinely infused prior to organ harvesting since it is believed to improve pulmonary grafts by minimizing thrombosis formation in the pulmonary grafts. Here, we raise the question of whether or not the use of heparin in HBDs improves the quality of the pulmonary grafts. Methods. Twelve landrace pigs were divided into two groups of six animals; heparin was given prior to lung harvesting in one group, while the other group did not receive any heparin. The lungs were evaluated using an ex vivo lung perfusion (EVLP) method. Results. No significant difference in arterial oxygen partial pressure (PaO₂) was observed between the two groups at an inspired oxygen fraction (FiO₂) of 1.0 (mean 69.2 kPa, range 46.1–77.0 in the non-heparin group, and 61.6 kPa, range 47.9–71.4 in the heparin group, p = 0.44), neither in pulmonary vascular resistance: mean 543 ((dyne × s)/cm⁵) (range 280–615) in the non-heparin group and 533 ((dyne × s)/cm⁵) (320–762) in the heparin group (p = 0.99). Conclusions. Heparin did not seem to improve pulmonary graft function in our animal model using conventional HBDs.

Key words::

• ex vivo lung perfusion
• heparin
• lung transplantation
• pulmonary graft

Declaration of interest: The authors report no declarations of interest. The authors alone are responsible for the content and writing of the paper.