Isolated total lung perfusion as a means to deliver organ-specific chemotherapy: long-term studies in animals
The objectives of this study were to develop a surgical procedure that would allow for bilateral isolated lung perfusion in vivo as a means of delivering organ-specific chemotherapy and to evaluate the influence of the procedure on certain pulmonary physiologic parameters. The sterile surgical procedure that was carried out in dogs involved the setting up of two separate perfusion circuits. Once standard systemic cardiopulmonary bypass was established, a second circuit was devised to perfuse the lungs by placing an inflow cannula into the main pulmonary artery and collecting venous effluent in the left atrium. Cross-contamination between perfusion circuits was determined in acute studies with labeled plasma protein or red blood cells and was found to be in an acceptable range if the aorta was cross-clamped and the heart arrested. Only about 0.4 ml/min of pulmonary perfusate leaked into the systemic circulation, indicating that systemic toxicity should not be a major concern when chemotherapy agents are added to the pulmonary perfusate. Chronic studies demonstrated that hemodynamic parameters, lung water, pulmonary endothelial serotonin extraction, and histologic findings all showed minimal changes after 50 minutes of isolated lung perfusion. Five days after perfusion, lung dynamic compliance and peak serotonin extraction showed significant decreases. However, all of the measured parameters had returned toward baseline levels by the end of the 8-week postoperative study period. The procedure offers significant advantages over the previously described single lung perfusion and may provide a method of delivering immediate high-concentration adjuvant chemotherapy to coincide with resection of primary or metastatic lung tumors.
- Research Organization:
- Medical College of Wisconsin, Milwaukee
- OSTI ID:
- 5220224
- Journal Information:
- Surgery; (United States), Vol. 1
- Country of Publication:
- United States
- Language:
- English
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59 BASIC BIOLOGICAL SCIENCES
HEART
SURGERY
LUNGS
PERFUSED ORGANS
DYNAMIC FUNCTION STUDIES
BIOPSY
BLOOD CIRCULATION
CHEMOTHERAPY
DOGS
ERYTHROCYTES
IN VIVO
RADIOISOTOPES
SEROTONIN
AMINES
ANIMALS
AROMATICS
AUTONOMIC NERVOUS SYSTEM AGENTS
AZAARENES
AZOLES
BIOLOGICAL MATERIALS
BLOOD
BLOOD CELLS
BODY
BODY FLUIDS
CARDIOVASCULAR SYSTEM
DIAGNOSTIC TECHNIQUES
DRUGS
HETEROCYCLIC COMPOUNDS
HYDROXY COMPOUNDS
INDOLES
ISOTOPES
MAMMALS
MATERIALS
MEDICINE
NEUROREGULATORS
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANS
PYRROLES
RADIOPROTECTIVE SUBSTANCES
RESPIRATORY SYSTEM
SYMPATHOMIMETICS
THERAPY
TRYPTAMINES
VERTEBRATES
550600* - Medicine
551001 - Physiological Systems- Tracer Techniques