Heart and lung transplantation: autotransplantation and allotransplantation in primates with extended survival

Combined heart and lung transplantation was performed in rhesus or cynomolgus monkeys in order to confirm the ability of primates to withstand complete cardiopulmonary denervation, to develop a satisfactory operative method, and to obtain survival of allotransplant recipients using Cyclosporin-A immune suppression. Twenty-seven monkeys weighing 2.6 to 10.1 kg received either autotransplants or allotransplants by two different operative techniques. Seventeen animals were operated upon with hypothermia and circulatory arrest. One autotransplant recipient is alive at 368 days, but all allotransplant recipients (untreated) died within 5 days despite normal breathing patterns. Ten animals operated upon with the aid of cardiopulmonary bypass fared better. Three autotransplant recipients are alive 60, 199, and 312 days postoperatively. Three of seven allotransplant recipients treated with Cyclosporin-A (25 mg/kg, then tapered) and azathioprine (2 mg/kg for 14 days) were long-term survivors. One died at 144 days of lymphoma and two are currently living 156 and 191 days postoperatively. The results suggest that heart and lung transplantation is possible in primates and that allografted recipients can survive for extended periods with Cyclosporin-A used for immune suppression.

A technical modification of heart-lung transplantation in rats

Hemodynamic studies were carried out on a series of rats undergoing heart-lung transplantation according to the technique of Sun Lee. The results suggested a new hypothesis of blood circulation in the heart-lung block by demonstrating the lack of necessity for the venovenous anastomosis. A new technique, with just one aortoaortic anastomosis, was therefore evaluated. Its value and reliability in a series of 30 rats are discussed.

Heterotopic heart and lung transplantation in the rat

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