Issue |
J Extra Corpor Technol
Volume 18, Number 2, June 1986
|
|
---|---|---|
Page(s) | 41 - 45 | |
DOI | https://doi.org/10.1051/ject/1986182041 | |
Published online | 12 September 2023 |
Original Article
Isolated Total Lung Perfusion Technique for Chemotherapy
1
PSICOR
2
University of Colorado Health Sciences Center, Denver, CO
* Direct communications to: Kim M. Schavey, C.C.P., Bronson Medical Center West, % Charles F. Butler, M.D., 252 East Lovell, Suite 217, Kalamazoo, MI 49007
A perfusion technique was developed in the laboratory to isolate the pulmonary vasculature from the systemic circulation to administer chemotherapy selectively to the lungs.
Dogs weighing between 20 to 30 kilograms were placed on total cardiopulmonary bypass via cannulation of the femoral artery and inferior and superior vena cava. The aorta was cross clamped and the heart arrested with crystalloid cardioplegia to minimize collateral blood flow into the pulmonary circuit. The pulmonary artery and the left atrium were then cannulated for isolated pulmonary perfusion. Cisplatin was added to the pulmonary circuit and the lungs perfused for fifty minutes at normothermia. Following termination of pulmonary perfusion, the pulmonary vasculature was flushed with Dextran, the cross clamp removed and the lungs returned to systemic circulation. Cardiopulmonary bypass was terminated and the dogs recovered.
Random biopsies demonstrated uniform drug uptake throughout the lung tissue. Simultaneous sampling of systemic drug levels showed no crossover from the pulmonic to the systemic circuit thus indicating a truly isolated perfusion technique. Systemic crossover to the pulmonary circuit from the noncoronary collateral blood flow was minimized by controlling the perfusion parameters of both circuits. Hemopoietic depression from the cytotoxic drug and lung damage from the perfusion technique were both minimal.
A technique for isolated in-situ total lung perfusion for the treatment of lung cancers has been developed which allows delivery of high drug concentrations to the tumor, thus enhancing the possibility of reaching cytotoxic levels within the tumor, while avoiding systemic toxicity.
© 1986 AMSECT
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