RESUMO
BACKGROUND: Necrosis of the bronchial stump is a very important trigger for bronchopleural fistula. The administration of local autologous platelet-poor plasma (PPP) could protect the bronchial stump. MATERIALS AND METHODS: Left pneumonectomy was performed in 25 Sprague-Dawley rats. Animals were randomly assigned to a control group (n=13) and PPP group (n=12). PPP was locally administered on the bronchial stump after pneumonectomy. We analyzed histologic changes in the bronchial stump and messenger RNA expression changes of genes involved in wound repair at 10 and 20 d. RESULTS: Local PPP treatment produced a mass of fibrous tissue surrounding the bronchial stump and significantly decreased the presence of necrosis at 20 d. PPP increased the expression of insulin like growth factor 1 at 10 d although it did not reach statistical significance. CONCLUSIONS: Our findings indicate that local PPP treatment of the bronchial stump after pneumonectomy decreased necrosis and could have a protective effect on the bronchial stump.
Assuntos
Brônquios/patologia , Fístula Brônquica/prevenção & controle , Plasma , Doenças Pleurais/prevenção & controle , Pneumonectomia/efeitos adversos , Animais , Transfusão de Sangue Autóloga , Fístula Brônquica/etiologia , Expressão Gênica , Fator de Crescimento Insulin-Like I/metabolismo , Masculino , Necrose/etiologia , Necrose/prevenção & controle , Doenças Pleurais/etiologia , Ratos , Ratos Sprague-Dawley , CicatrizaçãoRESUMO
BACKGROUND: Microsurgical lung transplantation in rats has allowed us to obtain new knowledge about lung transplantation. However, some aspects in human transplantation technique still have not been included in this model, which could interfere with the clinical interpretation and extrapolation of results. METHODS: Twenty left lung transplantations were performed with a cuff technique and technical modifications, such as brain death induction, the control of ischemia time and retrograde perfusion in the donor and the controlled sequential reperfusion of the implanted lung in the recipient. RESULTS: Survival rate was 80%. The transplanted lungs showed proper perfusion and ventilation with good permeability of the anastomoses. Signs of ischemia-reperfusion injury were observed in all animals while mild acute rejection was seen in half of them. CONCLUSIONS: The model shown proves valid and is very similar to the procedure carried out in humans, which would reduce the number of possible variables derived from the surgical technique when extrapolating the study results to clinical use.