Work

Chest wall strapping in a porcine model: A model for the physiology of the oversized lung allograft

Year: 2025

Type: article

Abstract: Restrictive lung disease (RLD) is the leading indication for lung transplantation. Donor-to-recipient size matching is challenging in RLD, especially oversizing. Chest-Wall-Strapping (CWS) is a technique forcing the lung to operate at lower volumes. We developed a porcine model of CWS to investigate limits of oversizing. Farm-raised pigs were intubated and mechanically ventilated. Computer tomography (CT) volumetry demonstrated that Total Lung Volume (TLV) at 25cmH 2 O end-expiratory pressure was 1,204 ml at baseline. Application of increasing doses of CWS reduced TLV to 879 ml (CWS-cuff inflated to 35 mmHg) and reduced TLV to 620 ml (CWS-cuff inflated to 50 mmHg). At 50 mmHg of CWS (50% TLV reduction) atelectasis of the lung bases was evident. Lung elastance was increased with CWS. CT lung-density at 35 mmHg CWS (30% reduction in TLV) was normal for the inflation state of the lung. Physiological limits of oversizing should be considered for optimal lung function.

Source: JHLT Open

DOI: 10.1016/j.jhlto.2025.100248

Authors: Eric Abston, Michael Eberlein

Institutions: Massachusetts General Hospital, University of Wisconsin–Madison

Language: English

Topic: Transplantation: Methods and Outcomes

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,500