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BACKGROUND: Although lung transplantation is a well-accepted treatment for end-stage lung diseases patients, only 15%-20% of the brain-dead donors' lungs are usable for transplantation. This results in high mortality of candidates on waiting lists. Ex-vivo lung perfusion (EVLP) is a novel method for better evaluation of a potential lung for transplantation. OBJECTIVE: To report the first experience of EVLP in Iran. METHODS: The study included a pig in Vienna Medical University, Vienna, Austria, and 4 humans in Masih Daneshvari Hospital, Tehran, Iran. All brain-dead donors from 2013 to 2015 in Tehran were evaluated for EVLP. Donors without signs of severe chest trauma or pneumonia, with poor oxygenation were included. RESULTS: An increasing trend in difference between the pulmonary arterial pO2 and left atrial pO2, an increasing pattern in dynamic lung compliance, and a decreasing trend in the pulmonary vascular resistance, were observed. CONCLUSION: The initial experience of EVLP in Iran was successful in terms of important/critical parameters. The results emphasize on some important considerations such as precisely following standard lung harvesting and monitoring temperature and pressure. EVLP technique may not be a cost-effective option for low-income countries at first glance. However, because this is the only therapeutic treatment for end-stage lung disease, it is advisable to continue working on this method to find alternatives with lesser costs.
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Saddle spinal is a reliable method for control of pain during labor. This method has rapid onset and causes complete sensory block without significant influence on motor neurons.Our goal was to compare the analgesic efficacy and side effects of pethidine and sufentanil via saddle spinal administration during labor.600 parturients requesting analgesia were randomly divided into 2 groups. First group was composed of 300 patients received 0.4 mg/kg pethidine and the second group was composed of 300 patients received 0.1 µg/kg sufentanil. Then, analgesia according to Visual Analogue Scale (VAS), itching, nausea, apnea and urinary retention were examined between 2 groups.VAS=3 was noted in both groups. Equal rate of apnea was seen in both groups. Patients received pethidine showed significantly a higher rate of nausea compared with sufentanil group (P<0.0001). Pruritus was significantly higher in patients received sufantanil (P<0.0001).Our findings suggest that saddle spinal by pethidine or sufentanil causes a considerable analgesia for labor. Proper management of the untoward effects of this method may introduce it as a safe and low-cost method for painless labor.