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estos modelos experimentales han favorecido el desarrollo del procedimiento quir&#250;rgico y la prevenci&#243;n de las complicaciones asociadas al mismo&#44; como el rechazo o la lesi&#243;n por isquemia-reperfusi&#243;n&#46; Aunque el primer trasplante murino se efectu&#243; en 1971<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">6</span></a>&#44; durante el siglo pasado se realizaron fundamentalmente en el perro<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">4&#44;5</span></a>&#44; as&#237; como en cerdo&#44; oveja<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">7</span></a> o mono<a class="elsevierStyleCrossRefs" href="#bib0370"><span class="elsevierStyleSup">8-10</span></a>&#44; ya que los animales de mayor tama&#241;o presentan ventajas a la hora de desarrollar la t&#233;cnica quir&#250;rgica y de trasladar los resultados a la cl&#237;nica humana&#46; Actualmente&#44; estas especies se siguen empleando&#44; sobre todo para el entrenamiento quir&#250;rgico&#44; mientras que han adquirido un mayor protagonismo especies de menor tama&#241;o como el conejo<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">11</span></a>&#44; la rata o el rat&#243;n&#44; que proporcionan ventajas econ&#243;micas&#44; log&#237;sticas y de manejo&#44; as&#237; como menos limitaciones &#233;ticas&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">En la rata&#44; se desarroll&#243; inicialmente el trasplante ortot&#243;pico de pulm&#243;n izquierdo<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">6</span></a>&#44; mientras que el de todo el bloque cardiopulmonar tiene un uso m&#225;s limitado por su elevada mortalidad<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">12</span></a>&#46; Las mejoras en el procedimiento quir&#250;rgico&#44; en la t&#233;cnica anest&#233;sica&#44; en la ventilaci&#243;n mec&#225;nica y en las condiciones de preservaci&#243;n y reperfusi&#243;n han permitido no solo el &#233;xito del modelo sino tambi&#233;n su reproducibilidad&#46; Adem&#225;s&#44; se han desarrollado modelos de trasplantes heterot&#243;picos&#44; aunque estos carecen de ventilaci&#243;n y buena perfusi&#243;n del injerto<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">13&#44;14</span></a>&#46; Por &#250;ltimo&#44; la disponibilidad de una gran diversidad de cepas&#44; que permiten estudiar factores gen&#233;ticos que afectan al trasplante&#44; ha potenciado el modelo en rat&#243;n<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">15&#44;16</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">En esta revisi&#243;n pretendemos describir los distintos procedimientos disponibles para el trasplante pulmonar murino&#44; incidiendo en la t&#233;cnica quir&#250;rgica y en aspectos perioperatorios relevantes&#44; como anestesia-analgesia&#44; ventilaci&#243;n mec&#225;nica&#44; manejo del postoperatorio y prevenci&#243;n de complicaciones&#46; Adem&#225;s&#44; revisaremos las principales aportaciones generadas por el trasplante pulmonar en roedores&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Anestesia y cuidados perioperatorios</span><p id="par0025" class="elsevierStylePara elsevierViewall">Los protocolos anest&#233;sicos deben proporcionar un adecuado efecto anest&#233;sico y analg&#233;sico&#44; manteniendo la estabilidad fisiol&#243;gica del animal y ser f&#225;cilmente reversibles al finalizar la t&#233;cnica quir&#250;rgica&#46; Aunque permite una r&#225;pida inducci&#243;n y recuperaci&#243;n del animal&#44; el uso de anestesia inhalatoria<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">16</span></a> &#40;isoflurano al 1&#44;5-2&#37; o sevoflurano al 2&#44;5-3&#37;&#44; cuyo efecto protector sobre el pulm&#243;n es conocido<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">17</span></a>&#41; puede generar dificultades si no se dispone de los medios adecuados&#46; En concreto&#44; se requieren recursos econ&#243;micos&#44; debido al elevado coste y gasto de los anest&#233;sicos inhalatorios&#44; as&#237; como la disponibilidad de un equipo de ventilaci&#243;n mec&#225;nica que permita la introducci&#243;n de gases anest&#233;sicos&#46; Por ello&#44; cuando no es posible realizar una anestesia inhalatoria se puede recurrir a m&#233;todos parenterales &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">La ketamina es uno de los f&#225;rmacos m&#225;s empleados y proporciona un efecto analg&#233;sico&#44; potenciado cuando se administra conjuntamente con un agonista de los receptores &#945;2-adren&#233;rgicos&#44; como la xilacina o la medetomidina&#44; a la vez que reduce la rigidez muscular&#46; Esta combinaci&#243;n anest&#233;sica se puede revertir f&#225;cilmente con la administraci&#243;n de un antagonista de los receptores &#945;2-adren&#233;rgicos como el atipamezol&#46; Otras combinaciones emplean ketamina y la benzodiacepina diacepam&#44; o el opioide fentanilo asociado a la medetomidina&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Es necesario compensar la diuresis causada por los agonistas de los receptores &#945;2-adren&#233;rgicos mediante fluidoterapia subcut&#225;nea&#46; Adem&#225;s&#44; resulta importante la aplicaci&#243;n de pomadas oft&#225;lmicas para evitar la sequedad corneal&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">La toracotom&#237;a es un potente est&#237;mulo nociceptivo&#44; por lo que una analgesia apropiada resulta esencial&#46; Normalmente&#44; se basa en la administraci&#243;n preoperatoria subcut&#225;nea de opioides &#40;como buprenorfina&#44; a 10-50<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;kg&#47;8<span class="elsevierStyleHsp" style=""></span>h en rata o 50-100<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;kg&#47;8<span class="elsevierStyleHsp" style=""></span>h en rat&#243;n&#41; asociados a antiinflamatorios no esteroideos &#40;2<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;d&#237;a de meloxicam&#41;&#46; Finalmente&#44; se recomienda realizar profilaxis antibi&#243;tica con cefazolina &#40;30<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#41; o ceftriaxona &#40;70<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#41;&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Ventilaci&#243;n</span><p id="par0045" class="elsevierStylePara elsevierViewall">Una vez anestesiados&#44; los animales deben ser intubados con cat&#233;teres de 14<span class="elsevierStyleHsp" style=""></span>G &#40;ratas &#62;<span class="elsevierStyleHsp" style=""></span>300<span class="elsevierStyleHsp" style=""></span>g&#41;&#44; 16 G &#40;rata de 200-300<span class="elsevierStyleHsp" style=""></span>g&#41; o 22 G &#40;ratones de unos 25<span class="elsevierStyleHsp" style=""></span>g&#41; y ventilados mec&#225;nicamente&#46; En el caso del receptor&#44; suele recomendarse el modo de ciclado por presi&#243;n&#44; dado que su pulm&#243;n izquierdo no ser&#225; funcional durante gran parte de la cirug&#237;a&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Para la programaci&#243;n del ventilador&#44; se recomienda establecer un volumen corriente de 7-10<span class="elsevierStyleHsp" style=""></span>ml&#47;kg &#40;si est&#225; ciclado por volumen&#41;&#44; una presi&#243;n m&#225;xima de 10-12<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O &#40;si est&#225; ciclado por presi&#243;n&#41; y una frecuencia respiratoria de 60-100 respiraciones&#47;min&#46; Adem&#225;s&#44; es muy recomendable aplicar una presi&#243;n positiva al final de la espiraci&#243;n de 2-5<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O para evitar la formaci&#243;n de atelectasias durante la espiraci&#243;n&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Monitorizaci&#243;n intraoperatoria</span><p id="par0055" class="elsevierStylePara elsevierViewall">Existen equipamientos espec&#237;ficos para roedores que permiten el registro de pulsioximetr&#237;a&#44; capnograf&#237;a&#44; presiones arteriales no invasivas o electrocardiograma&#46; En general&#44; los equipos dise&#241;ados para humanos o para animales de mayor tama&#241;o no son adecuados para roedores&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Adem&#225;s&#44; es relevante monitorizar la temperatura corporal mediante un term&#243;metro o sonda rectal para mantenerla entre 37&#44;5-38&#44;5<span class="elsevierStyleHsp" style=""></span>&#176;C&#46; La hipotermia es una complicaci&#243;n muy frecuente en roedores y produce muchos efectos adversos si se alcanzan temperaturas inferiores a 32<span class="elsevierStyleHsp" style=""></span>&#176;C&#44; incluyendo un retraso en la recuperaci&#243;n de la anestesia&#46; Para mantener la temperatura corporal&#44; se emplea una manta el&#233;ctrica o de agua caliente&#44; aunque vigilando la posible hipertermia que pueda provocar&#46; La saturaci&#243;n de oxihemoglobina suele mantenerse en niveles superiores al 99&#37; cuando la fracci&#243;n inspirada de ox&#237;geno se incrementa entre un 30 o 60&#37; con respecto al 21&#37; del aire ambiental&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Aspectos quir&#250;rgicos del trasplante pulmonar ortot&#243;pico en rata y rat&#243;n</span><p id="par0065" class="elsevierStylePara elsevierViewall">El modelo de trasplante ortot&#243;pico del pulm&#243;n izquierdo es el m&#225;s utilizado por su viabilidad y mayor sencillez&#44; ya que el pulm&#243;n izquierdo est&#225; formado por un &#250;nico l&#243;bulo&#44; mientras que el derecho se divide en 4&#46; No obstante&#44; en el rat&#243;n tambi&#233;n se ha utilizado el trasplante ortot&#243;pico del pulm&#243;n derecho<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">18</span></a>&#46;</p><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Preparaci&#243;n del donante</span><p id="par0070" class="elsevierStylePara elsevierViewall">Suele recomendarse la extracci&#243;n de todo el bloque cardiopulmonar&#46; Bajo anestesia y con el animal en dec&#250;bito supino&#44; se prepara el campo operatorio rasurando la piel del t&#243;rax y aplicando povidona iodada o clorhexidina de forma centr&#237;peta desde el centro del t&#243;rax&#46; Posteriormente&#44; se realiza una esternotom&#237;a media con heparinizaci&#243;n &#40;100<span class="elsevierStyleHsp" style=""></span>UI&#47;100<span class="elsevierStyleHsp" style=""></span>g&#41; en vena cava inferior&#44; subcut&#225;nea o intracard&#237;aca&#44; para evitar la formaci&#243;n de co&#225;gulos en el pulm&#243;n a trasplantar&#46; Con un microscopio &#243;ptico&#44; se procede a la disecci&#243;n del hilio pulmonar para localizar el cayado a&#243;rtico y pinzarlo&#46; Simult&#225;neamente&#44; se realizan cortes a nivel de las aur&#237;culas y vena cava inferior&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">En la mayor&#237;a de los modelos se lleva a cabo una perfusi&#243;n anter&#243;grada&#44; a trav&#233;s del ventr&#237;culo derecho<a class="elsevierStyleCrossRefs" href="#bib0425"><span class="elsevierStyleSup">19&#44;20</span></a> o del tronco pulmonar<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">15&#44;21&#8211;23</span></a>&#44; aunque es conveniente combinarla con la perfusi&#243;n retr&#243;grada desde la aur&#237;cula izquierda<a class="elsevierStyleCrossRef" href="#bib0440"><span class="elsevierStyleSup">22</span></a> para simular las condiciones fisiol&#243;gicas&#46; Los pulmones deben ser perfundidos a una presi&#243;n mantenida &#40;10-15<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#41;&#44; de forma homog&#233;nea&#44; con una soluci&#243;n de preservaci&#243;n fr&#237;a &#40;4<span class="elsevierStyleHsp" style=""></span>&#176;C&#41; de glucosa dextrano bajo en potasio &#40;LDPG&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">A continuaci&#243;n&#44; se liga y secciona la tr&#225;quea para extraer todo el bloque cardiopulmonar con el pulm&#243;n insuflado&#44; para evitar la formaci&#243;n de atelectasias y mejorar la oxigenaci&#243;n y la presencia de surfactante&#44; lo que reduce el da&#241;o isquemia-reperfusi&#243;n<a class="elsevierStyleCrossRefs" href="#bib0450"><span class="elsevierStyleSup">24&#44;25</span></a>&#46; Las recomendaciones de inflado var&#237;an entre un 50&#37; de la capacidad pulmonar total<a class="elsevierStyleCrossRefs" href="#bib0440"><span class="elsevierStyleSup">22&#44;25</span></a> y un 75-100&#37;<a class="elsevierStyleCrossRef" href="#bib0460"><span class="elsevierStyleSup">26</span></a> sin llegar a provocar barotrauma&#46; Adem&#225;s&#44; el insuflado previo a la preservaci&#243;n reduce la expresi&#243;n de marcadores proinflamatorios tras la reperfusi&#243;n<a class="elsevierStyleCrossRef" href="#bib0460"><span class="elsevierStyleSup">26</span></a>&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Con respecto a la preservaci&#243;n del &#243;rgano trasplantado&#44; el pulm&#243;n donante se suele mantener a 4<span class="elsevierStyleHsp" style=""></span>&#176;C para minimizar el da&#241;o isqu&#233;mico del injerto pulmonar<a class="elsevierStyleCrossRef" href="#bib0465"><span class="elsevierStyleSup">27</span></a>&#46; La soluci&#243;n de preservaci&#243;n m&#225;s utilizada es el dextrano bajo en potasio &#40;Perfadex&#41;<a class="elsevierStyleCrossRefs" href="#bib0410"><span class="elsevierStyleSup">16&#44;28-30</span></a>&#44; aunque tambi&#233;n se emplean otras soluciones&#44; como Celsior<a class="elsevierStyleCrossRef" href="#bib0485"><span class="elsevierStyleSup">31</span></a>&#44; Euro-Collins o Wisconsin<a class="elsevierStyleCrossRef" href="#bib0450"><span class="elsevierStyleSup">24</span></a>&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Preparaci&#243;n del injerto</span><p id="par0090" class="elsevierStylePara elsevierViewall">Una vez extra&#237;do el bloque pulmonar&#44; se debe individualizar el pulm&#243;n izquierdo pinzando el bronquio para mantenerlo insuflado&#46; Junto con la arteria y vena pulmonares&#44; se secciona el bronquio lo m&#225;s distal posible al pulm&#243;n para facilitar las anastomosis &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">La preparaci&#243;n del pulm&#243;n izquierdo variar&#225; en funci&#243;n de la forma de realizar las anastomosis&#58; anastomosis vascular y bronquial con puntos de sutura<a class="elsevierStyleCrossRefs" href="#bib0360"><span class="elsevierStyleSup">6&#44;19&#44;21&#44;32</span></a>&#44; anastomosis bronquial con puntos de sutura y empleo de manguitos vasculares o <span class="elsevierStyleItalic">cuffs</span><a class="elsevierStyleCrossRefs" href="#bib0480"><span class="elsevierStyleSup">30&#44;33-36</span></a>&#44; y anastomosis vascular y bronquial mediante manguitos<a class="elsevierStyleCrossRefs" href="#bib0430"><span class="elsevierStyleSup">20&#44;22&#44;23&#44;35-39</span></a> &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 2</a>&#41;&#46; En el primer caso&#44; se procede a la disecci&#243;n del hilio pulmonar individualizando cada estructura a anastomosar y manteniendo el pulm&#243;n en el medio de conservaci&#243;n a baja temperatura&#46; En los 2 &#250;ltimos casos&#44; las uniones vasculares y bronquiales se simplifican al no emplear suturas sino unos manguitos&#44; usados tanto en el trasplante pulmonar<a class="elsevierStyleCrossRef" href="#bib0495"><span class="elsevierStyleSup">33</span></a> como de otros &#243;rganos<a class="elsevierStyleCrossRefs" href="#bib0530"><span class="elsevierStyleSup">40-42</span></a>&#46; Se trata de estructuras anulares constituidas por policloruro de vinilo o tefl&#243;n&#44; fabricadas a partir de c&#225;nulas o cat&#233;teres&#44; cuyo tama&#241;o en la rata oscila de 18 a 14<span class="elsevierStyleHsp" style=""></span>G&#44; siendo los de mayor di&#225;metro los empleados en el bronquio&#44; y los m&#225;s peque&#241;os&#44; en la arteria pulmonar<a class="elsevierStyleCrossRef" href="#bib0440"><span class="elsevierStyleSup">22</span></a>&#46; Los manguitos tradicionales est&#225;n constituidos por un cuerpo&#44; que es donde se fijan los vasos o el bronquio&#44; y una leng&#252;eta para permitir una f&#225;cil manipulaci&#243;n de los mismos &#40;<a class="elsevierStyleCrossRef" href="#fig0025">fig&#46; 3</a>&#41;&#46; Su longitud es de 2-3<span class="elsevierStyleHsp" style=""></span>mm &#40;cuerpo de 1&#44; 1&#44;5 o 2<span class="elsevierStyleHsp" style=""></span>mm y leng&#252;eta de 1 o 1&#44;5<span class="elsevierStyleHsp" style=""></span>mm&#41;&#46; Existe un modelo modificado de manguitos en el que se ha eliminado la leng&#252;eta<a class="elsevierStyleCrossRefs" href="#bib0490"><span class="elsevierStyleSup">32&#44;36&#44;43</span></a>&#44; pero ello complica su manipulaci&#243;n&#46; Por este motivo&#44; algunos grupos utilizan el manguito convencional y&#44; tras realizar la anastomosis&#44; eliminan la leng&#252;eta<a class="elsevierStyleCrossRef" href="#bib0495"><span class="elsevierStyleSup">33</span></a>&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">Independientemente del tipo de manguito utilizado&#44; la colocaci&#243;n se realiza introduciendo la vena&#44; arteria o bronquio del pulm&#243;n donante a trav&#233;s del orificio del cuerpo del manguito&#44; para posteriormente evertirlos fijando los tejidos con sutura de polipropileno de 7&#47;0 o 8&#47;0 en la rata<a class="elsevierStyleCrossRefs" href="#bib0440"><span class="elsevierStyleSup">22&#44;23</span></a> y de 10&#47;0 en el rat&#243;n<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">18</span></a>&#46; En ocasiones&#44; el bronquio es preparado justo antes del momento del implante para evitar la entrada de l&#237;quido de preservaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0420"><span class="elsevierStyleSup">18&#44;20</span></a>&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Preparaci&#243;n del receptor</span><p id="par0105" class="elsevierStylePara elsevierViewall">Bajo anestesia y una adecuada analgesia&#44; se coloca al animal en dec&#250;bito lateral derecho&#46; Se prepara el campo quir&#250;rgico como en el animal donante y se realiza una toracotom&#237;a lateral a trav&#233;s del cuarto espacio intercostal&#46; Se extrae el pulm&#243;n izquierdo y se a&#237;slan las principales estructuras pinzando la arteria&#44; vena y bronquio pulmonares izquierdos&#44; siempre lo m&#225;s distal posible al pulm&#243;n&#46; La secci&#243;n de dichas estructuras se realiza lo m&#225;s pr&#243;ximo posible al par&#233;nquima pulmonar&#46; Para evitar la formaci&#243;n de co&#225;gulos&#44; se aplica suero heparinizado &#40;0&#44;5-1<span class="elsevierStyleHsp" style=""></span>UI&#47;ml&#41; a la arteria y vena&#46; La manipulaci&#243;n de todas las estructuras debe ser cuidadosa para evitar desgarros vasculares&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">A continuaci&#243;n&#44; se procede a realizar las anastomosis de las estructuras vasculares y del bronquio&#46; En la <a class="elsevierStyleCrossRef" href="#fig0035">figura 4</a> aparecen reflejadas&#44; en una imagen real&#44; las anastomosis realizadas con manguitos&#46;</p><elsevierMultimedia ident="fig0035"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">Una vez anastomosado el bronquio&#44; se debe ventilar el pulm&#243;n donante para evitar la formaci&#243;n de atelectasias y favorecer el reclutamiento alveolar&#46; Una r&#225;pida reperfusi&#243;n del pulm&#243;n indica que la permeabilidad vascular de las anastomosis es adecuada&#46; Por &#250;ltimo&#44; se extrae el pulm&#243;n nativo del animal receptor&#44; dejando &#250;nicamente el pulm&#243;n donante&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">La colocaci&#243;n de un drenaje es fundamental para eliminar los restos de sangre&#44; l&#237;quido o aire alrededor de los pulmones y que estos se puedan expandir con normalidad&#46; El cierre de la cavidad tor&#225;cica se realiza por planos&#44; retirando el drenaje cuando el animal se recupera de la anestesia y comienza su ventilaci&#243;n espont&#225;nea&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">En funci&#243;n del grupo de trabajo y de la t&#233;cnica empleada&#44; el tiempo necesario para completar la cirug&#237;a var&#237;a&#46; Por lo general&#44; se observan tiempos m&#225;s bajos cuando se emplea la t&#233;cnica de <span class="elsevierStyleItalic">cuff</span> que cuando se emplean suturas convencionales&#44; especialmente&#44; cuando esto &#250;ltimo se realiza en vasos y bronquio&#46; De igual manera&#44; el &#237;ndice de supervivencia es mejor cuando en las anastomosis se utilizan manguitos frente a puntos de sutura &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Cuidados postoperatorios</span><p id="par0130" class="elsevierStylePara elsevierViewall">Tras la cirug&#237;a&#44; se debe mantener el tratamiento analg&#233;sico y antibi&#243;tico durante al menos 5-6 d&#237;as&#44; increment&#225;ndose la analgesia si se detecta dolor&#46; La herida quir&#250;rgica se debe limpiar y desinfectar para favorecer la cicatrizaci&#243;n&#46; Tambi&#233;n es necesario establecer protocolos de supervisi&#243;n e incluir criterios de punto final&#44; valorar aspectos como la p&#233;rdida de peso&#44; el aspecto f&#237;sico&#44; el patr&#243;n ventilatorio&#44; la presencia de cianosis o el comportamiento del animal&#46; Cuando se produzcan alteraciones de los mismos&#44; ser&#225; necesario llevar a cabo actividades correctoras inmediatas&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Complicaciones perioperatorias y su manejo</span><p id="par0135" class="elsevierStylePara elsevierViewall">Las m&#225;s importantes son derivadas del procedimiento quir&#250;rgico&#44; tanto en la preparaci&#243;n del donante como del receptor<a class="elsevierStyleCrossRef" href="#bib0550"><span class="elsevierStyleSup">44</span></a>&#46; Para lograr habilidad en el manejo del material microquir&#250;rgico y&#44; por tanto&#44; alcanzar &#233;xito en la t&#233;cnica quir&#250;rgica&#44; se requiere una curva de aprendizaje relativamente larga&#44; con una alta mortalidad durante la puesta a punto de la cirug&#237;a<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">15</span></a>&#46; Algunos autores establecen en 50 trasplantes el umbral para dominar la t&#233;cnica<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">20</span></a>&#46; Adem&#225;s&#44; la duraci&#243;n del procedimiento quir&#250;rgico y el tiempo empleado en la realizaci&#243;n de las anastomosis influyen en la aparici&#243;n de complicaciones y en la supervivencia de los animales<a class="elsevierStyleCrossRefs" href="#bib0360"><span class="elsevierStyleSup">6&#44;16&#44;30&#44;32&#44;44</span></a>&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">En general&#44; el uso de manguitos requiere menor habilidad y experiencia&#44; resultando un procedimiento m&#225;s r&#225;pido que la sutura con puntos simples<a class="elsevierStyleCrossRefs" href="#bib0520"><span class="elsevierStyleSup">38&#44;45</span></a>&#46; Los manguitos vasculares reducen el riesgo de sangrado y&#44; por ello&#44; se produce menos tejido de granulaci&#243;n&#44; disminuyendo la posibilidad de trombosis o estenosis a largo plazo de las zonas de anastomosis<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">38</span></a>&#46; En el bronquio&#44; se detecta una menor presencia de fugas&#44; factor causante de neumot&#243;rax&#44; lo que condiciona la funcionalidad del injerto<a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">35</span></a>&#46; No obstante&#44; el uso de manguitos puede originar una disminuci&#243;n de la luz si la elecci&#243;n de su di&#225;metro no es adecuada&#44; y puede provocar una reacci&#243;n de cuerpo extra&#241;o<a class="elsevierStyleCrossRefs" href="#bib0505"><span class="elsevierStyleSup">35&#44;38&#44;45</span></a>&#46; Los manguitos modificados&#44; sin extensiones o leng&#252;etas&#44; reducen el riesgo de torsi&#243;n de los vasos o bronquios tras realizar la anastomosis y el da&#241;o producido por dicha extensi&#243;n&#46; Adem&#225;s&#44; al ser m&#225;s peque&#241;os producen menos reacci&#243;n de cuerpo extra&#241;o<a class="elsevierStyleCrossRef" href="#bib0510"><span class="elsevierStyleSup">36</span></a>&#46; Otras complicaciones perioperatorias referidas incluyen la rotura de la vena cava&#44; el empiema pleural<a class="elsevierStyleCrossRef" href="#bib0500"><span class="elsevierStyleSup">34</span></a>&#44; la parada respiratoria<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">38</span></a> o la trombosis venosa<a class="elsevierStyleCrossRef" href="#bib0545"><span class="elsevierStyleSup">43</span></a>&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">En cuanto a complicaciones postoperatorias&#44; son importantes la insuficiencia respiratoria&#44; la hemoptisis&#44; la trombosis de una vena o arteria bronquial&#44; el neumot&#243;rax&#44; las infecciones respiratorias&#44; los derrames pleurales&#44; el edema pulmonar y el rechazo del injerto<a class="elsevierStyleCrossRefs" href="#bib0425"><span class="elsevierStyleSup">19&#44;46</span></a>&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Principales aportaciones cient&#237;ficas</span><p id="par0150" class="elsevierStylePara elsevierViewall">Pese a la complejidad quir&#250;rgica&#44; los modelos de trasplante pulmonar en roedores est&#225;n suficientemente estandarizados y son reproducibles&#44; lo que permite evaluar diferentes aspectos t&#233;cnicos y los mecanismos de las principales complicaciones del trasplante en humanos&#46; Hasta el momento&#44; el trasplante pulmonar murino ha facilitado la generaci&#243;n de conocimiento sobre las caracter&#237;sticas de los donantes<a class="elsevierStyleCrossRefs" href="#bib0440"><span class="elsevierStyleSup">22&#44;47</span></a>&#44; modelos de conservaci&#243;n y preservaci&#243;n pulmonar<a class="elsevierStyleCrossRefs" href="#bib0460"><span class="elsevierStyleSup">26&#44;48&#44;49</span></a>&#44; lesi&#243;n por isquemia-reperfusi&#243;n<a class="elsevierStyleCrossRefs" href="#bib0570"><span class="elsevierStyleSup">48&#44;50-52</span></a> y&#44; sobre todo&#44; rechazo agudo y cr&#243;nico &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;<a class="elsevierStyleCrossRefs" href="#bib0570"><span class="elsevierStyleSup">48&#44;53-66</span></a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Disfunci&#243;n primaria del injerto por lesi&#243;n isquemia-reperfusi&#243;n</span><p id="par0155" class="elsevierStylePara elsevierViewall">Aparece en las primeras 72<span class="elsevierStyleHsp" style=""></span>h y se grad&#250;a en funci&#243;n de la relaci&#243;n PaO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span> y la presencia de infiltrados radiol&#243;gicos&#44; siendo una causa muy importante de morbimortalidad durante el postoperatorio inmediato&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Su an&#225;lisis en modelos murinos ha permitido una mejor caracterizaci&#243;n de los mecanismos desencadenantes&#44; en los que la lesi&#243;n primaria de los neutr&#243;filos originada por la isquemia-reperfusi&#243;n parece desempe&#241;ar un papel nuclear&#46; As&#237;&#44; se ha demostrado que neutr&#243;filos aislados de las v&#237;as a&#233;reas de receptores de trasplante estimulan las c&#233;lulas dendr&#237;ticas del donante&#44; por un mecanismo dependiente de contacto&#44; para inducir la producci&#243;n de IL-12 y expandir linfocitos T espec&#237;ficos del aloant&#237;geno<a class="elsevierStyleCrossRef" href="#bib0580"><span class="elsevierStyleSup">50</span></a>&#46; A su vez&#44; se ha demostrado que este fen&#243;meno es regulado por la degranulaci&#243;n inducida por el TNF-&#945; asociado a la membrana plasm&#225;tica de los neutr&#243;filos<a class="elsevierStyleCrossRef" href="#bib0580"><span class="elsevierStyleSup">50</span></a>&#46; Tambi&#233;n ha sido posible identificar algunos factores moduladores de esta respuesta celular&#44; que podr&#237;an resultar de potencial inter&#233;s en la identificaci&#243;n de futuras v&#237;as terap&#233;uticas&#46; Se ha mostrado que el factor transcripcional Bcl3 limita la granulopoyesis por una v&#237;a NF-kB dependiente<a class="elsevierStyleCrossRef" href="#bib0585"><span class="elsevierStyleSup">51</span></a>&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Rechazo celular agudo</span><p id="par0165" class="elsevierStylePara elsevierViewall">Los modelos murinos proporcionan un medio ideal para el estudio del rechazo celular agudo&#44; al poder evaluar en cepas puras el grado de concordancia o discordancia del ant&#237;geno mayor de histocompatibilidad&#46; Esto resulta particularmente favorecido por el desarrollo de sistemas de monitorizaci&#243;n espec&#237;ficos para este modelo de trasplante&#46; Adem&#225;s de los lavados broncoalveolares para el estudio de la celularidad de las v&#237;as a&#233;reas y de medir la capacidad de oxigenaci&#243;n a trav&#233;s de los gases en sangre arterial&#44; se han generado t&#233;cnicas de imagen propias&#44; como la tomograf&#237;a volum&#233;trica<a class="elsevierStyleCrossRef" href="#bib0595"><span class="elsevierStyleSup">53</span></a> o la resonancia magn&#233;tica ultracorta<a class="elsevierStyleCrossRef" href="#bib0600"><span class="elsevierStyleSup">54</span></a>&#44; que junto con la evaluaci&#243;n histol&#243;gica de los cambios ultraestructurales del rechazo agudo mediante microscopia de barrido<a class="elsevierStyleCrossRef" href="#bib0605"><span class="elsevierStyleSup">55</span></a> facilitan una mejor monitorizaci&#243;n del pulm&#243;n trasplantado&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Tambi&#233;n se han desarrollado procedimientos complementarios para la evaluaci&#243;n de la funci&#243;n pulmonar&#46; As&#237;&#44; la oscilaci&#243;n forzada resulta muy &#250;til en los modelos murinos&#44; ya que tanto la elastancia din&#225;mica como la dependencia de frecuencia de las resistencias parecen tener capacidad predictiva del grado de rechazo agudo<a class="elsevierStyleCrossRef" href="#bib0610"><span class="elsevierStyleSup">56</span></a>&#44; constituy&#233;ndose como &#237;ndices no invasivos para la detecci&#243;n y monitorizaci&#243;n de su progresi&#243;n&#46; En un &#225;mbito de imagen-funci&#243;n&#44; la microtomograf&#237;a de emisi&#243;n de positrones permite identificar un mayor consumo de <span class="elsevierStyleSup">18</span>fluorodesoxiglucosa por neutr&#243;filos y linfocitos CD8<a class="elsevierStyleCrossRef" href="#bib0615"><span class="elsevierStyleSup">57</span></a>&#44; pudiendo identificar m&#225;s precisamente el rechazo agudo a trav&#233;s de la valoraci&#243;n del metabolismo de las c&#233;lulas T&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">La evaluaci&#243;n de los mecanismos patog&#233;nicos del rechazo agudo en modelos murinos ha facilitado el desarrollo de intervenciones para prolongar la supervivencia del injerto&#44; por ejemplo&#44; mediante el bloqueo de los coestimuladores anti-CD28-B7 y del ligando CD40-CD40<a class="elsevierStyleCrossRef" href="#bib0620"><span class="elsevierStyleSup">58</span></a>&#46; Otros autores han demostrado en un modelo de trasplante pulmonar ortot&#243;pico murino MHC-discordante que la monoterapia con anticuerpos anti-CD154 podr&#237;a ser suficiente para atenuar el rechazo agudo<a class="elsevierStyleCrossRef" href="#bib0625"><span class="elsevierStyleSup">59</span></a>&#44; debido a un bloqueo de la coestimulaci&#243;n CD154&#47;CD40&#44; que favorece un desplazamiento del entorno del injerto hacia un predominio de c&#233;lulas T reguladoras CD4&#40;&#43;&#41; CD25&#40;&#43;&#41; Foxp3&#40;&#43;&#41;<a class="elsevierStyleCrossRef" href="#bib0630"><span class="elsevierStyleSup">60</span></a>&#46; Tambi&#233;n se ha referido que algunas c&#233;lulas pulmonares no hematopoy&#233;ticas pueden desempe&#241;ar un importante papel en la supresi&#243;n in vivo de las respuestas inmunes mediadas por c&#233;lulas T CD4&#40;&#43;&#41;<a class="elsevierStyleCrossRef" href="#bib0635"><span class="elsevierStyleSup">61</span></a>&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Aunque todav&#237;a muy incipiente&#44; estos hallazgos podr&#237;an tener una potencial traslaci&#243;n cl&#237;nica mediante el tratamiento con N-acetilciste&#237;na&#46; En modelos murinos&#44; se ha demostrado que su administraci&#243;n tiene capacidad para atenuar el rechazo pulmonar agudo por reducci&#243;n del infiltrado de macr&#243;fagos y c&#233;lulas T&#44; que est&#225; &#237;ntimamente relacionada con la disminuci&#243;n de la v&#237;a de se&#241;alizaci&#243;n inflamatoria mediada por NF-kB<a class="elsevierStyleCrossRef" href="#bib0640"><span class="elsevierStyleSup">62</span></a>&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Rechazo cr&#243;nico</span><p id="par0185" class="elsevierStylePara elsevierViewall">Suele manifestarse mediante el desarrollo de bronquiolitis obliterante&#44; debida a una infiltraci&#243;n celular de linfocitos y neutr&#243;filos atribuida a un conjunto de factores&#44; como una activaci&#243;n excesiva de la respuesta del sistema inmune innato&#44; una angiog&#233;nesis anormal o una inadecuada regeneraci&#243;n epitelial y remodelado del tejido linfoproliferativo<a class="elsevierStyleCrossRef" href="#bib0570"><span class="elsevierStyleSup">48</span></a>&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Aunque cada modelo animal tiene ventajas y limitaciones para el estudio de la bronquiolitis obliterante&#44; el modelo de bronquiolitis obliterante secundario al trasplante pulmonar murino resulta m&#225;s pr&#243;ximo al rechazo cr&#243;nico humano que otros modelos de bronquiolitis obliterante inducida por agentes qu&#237;micos&#46; Adem&#225;s&#44; permite valorar de forma seriada tanto la funci&#243;n pulmonar como m&#250;ltiples alteraciones morfol&#243;gicas o en la funci&#243;n celular&#44; y probar la eficacia de diversos f&#225;rmacos&#46; Otra ventaja sustancial viene dada por la disponibilidad de cepas knock-out y transg&#233;nicas de modelos de m&#250;ltiples enfermedades humanas&#44; lo que permite reproducir situaciones de rechazo cr&#243;nico relativamente similares a las desarrolladas en distintas enfermedades respiratorias terminales&#44; as&#237; como evaluar la contribuci&#243;n de potenciales v&#237;as de se&#241;alizaci&#243;n&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Sin embargo&#44; algunos factores de la anatom&#237;a y fisiolog&#237;a del pulm&#243;n murino ocasionan dificultades de traslaci&#243;n&#46; En relaci&#243;n con los pulmones humanos&#44; los bronquiolos murinos tienen una disminuci&#243;n de las gl&#225;ndulas submucosas y un mayor n&#250;mero de c&#233;lulas Clara&#44; lo que genera un entorno protector frente a la lesi&#243;n del epitelio bronquiolar&#44; principalmente mediante la secreci&#243;n de prote&#237;na secretada por las c&#233;lulas Clara y una soluci&#243;n similar al surfactante pulmonar&#44; lo que determina una mayor lesi&#243;n vascular que epitelial en estos modelos de rechazo<a class="elsevierStyleCrossRef" href="#bib0620"><span class="elsevierStyleSup">58</span></a>&#46; No obstante&#44; en los &#250;ltimos a&#241;os se han realizado importantes avances en el desarrollo de diversos modelos de bronquiolitis obliterante en el rat&#243;n<a class="elsevierStyleCrossRefs" href="#bib0645"><span class="elsevierStyleSup">63-65</span></a>&#44; as&#237; como estudios con microarrays de ADN para evaluar el rechazo cr&#243;nico tras el trasplante<a class="elsevierStyleCrossRef" href="#bib0660"><span class="elsevierStyleSup">66</span></a>&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; se han producido importantes desarrollos t&#233;cnicos en el trasplante pulmonar murino&#44; permitiendo la elecci&#243;n de diversas alternativas quir&#250;rgicas con una notable viabilidad de los animales trasplantados&#46; Esto determina una mayor accesibilidad a estos modelos experimentales quir&#250;rgicos&#44; que han demostrado su capacidad para generar conocimiento sobre los mecanismos patog&#233;nicos de la lesi&#243;n por isquemia-reperfusi&#243;n y del rechazo&#44; con una potencial traslaci&#243;n al ser humano a medio plazo&#46;</p></span></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Financiaci&#243;n</span><p id="par0205" class="elsevierStylePara elsevierViewall">Este trabajo ha sido subvencionado por la ayuda FPU2013-01638 a Daniel Ruiz-P&#233;rez otorgada por el Ministerio de Educaci&#243;n&#44; Cultura y Deporte&#44; Espa&#241;a&#46; El financiador no tiene ning&#250;n papel en el dise&#241;o del estudio&#44; recogida y an&#225;lisis de los datos&#44; ni en la preparaci&#243;n del manuscrito&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicto de intereses</span><p id="par0210" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A lo largo de las &#250;ltimas d&#233;cadas&#44; el n&#250;mero de trasplantes pulmonares realizados como terapia final de muchas enfermedades respiratorias ha ido creciendo considerablemente&#44; tanto en la poblaci&#243;n adulta como a nivel pedi&#225;trico&#46; Sin embargo&#44; se hace muy necesario estudiar las causas por las que su supervivencia es relativamente baja en comparaci&#243;n con otros trasplantes de &#243;rganos&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Por ello&#44; desde mediados del siglo pasado comenzaron a realizarse trasplantes pulmonares experimentales&#44; cuya t&#233;cnica ha ido mejorando&#44; y se ha ampliado a distintas especies animales hasta llegar a los roedores&#46; La ventaja que presentan estas especies peque&#241;as ha facilitado que el modelo quir&#250;rgico se haya extendido y estandarizado&#44; permitiendo estudiar diferentes aspectos relacionados con las enfermedades respiratorias&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En esta revisi&#243;n se analizan las distintas modalidades t&#233;cnicas disponibles de trasplante experimental en rata y rat&#243;n&#44; destacando tanto la t&#233;cnica quir&#250;rgica como la anest&#233;sica o la monitorizaci&#243;n&#44; as&#237; como las principales aportaciones generadas por el trasplante pulmonar murino&#46;</p></span>"
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      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">In recent years&#44; the number of lung transplantations performed as the last option for many respiratory diseases has grown considerably&#44; both in adults and children&#46; However&#44; the causes for the relatively short survival of lungs compared to other organ transplants still need to be studied&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Techniques have improved since the 1950s when experimental lung transplantation began&#44; and the different animal species used now include rodents&#46; The advantage of using these small species is that the surgical model has been expanded and standardized&#44; and different respiratory problems can be studied&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">In this review we examine the different technical strategies used in experimental transplantation in rats and mice&#44; focusing on surgical techniques and anesthesia and monitoring methods&#44; and highlighting the major contributions of mouse lung transplantation to the field&#46;</p></span>"
      ]
    ]
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          "es" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Extracci&#243;n y preparaci&#243;n del pulm&#243;n donante&#46; Realizaci&#243;n de una estereotom&#237;a media y disecci&#243;n y extracci&#243;n del bloque cardiopulmonar&#46; Disecci&#243;n de la arteria pulmonar izquierda &#40;LPA&#41;&#44; vena pulmonares izquierdas &#40;LPV&#41; y del bronquio izquierdo &#40;LBr&#41;&#46;AO&#58; aorta tor&#225;cica&#59; IVC&#58; vena cava inferior&#59; LA&#58; aur&#237;cula derecha&#59; L SVC&#58; vena cava superior izquierda&#59; LL&#58; pulm&#243;n izquierdo&#59; RA&#58; aur&#237;cula izquierda&#59; RL&#58; pulm&#243;n derecho&#59; R SVC&#58; vena cava superior derecha&#46;</p>"
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      1 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
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        "descripcion" => array:1 [
          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">T&#233;cnicas quir&#250;rgicas descritas de trasplante pulmonar en modelos murinos&#46; A&#41; Anastomosis vascular y bronquial con puntos de sutura&#46; B&#41; Anastomosis bronquial con puntos de sutura y empleo de manguitos vasculares o <span class="elsevierStyleItalic">cuffs</span> en vena y arteria pulmonares&#46; C&#41; Anastomosis vascular y bronquial mediante manguitos o <span class="elsevierStyleItalic">cuffs</span>&#46;LBr d&#58; bronquio izquierdo de animal donante&#59; LBr r&#58; bronquio izquierdo de animal receptor&#59; LPA d&#58; arteria pulmonar izquierda de animal donante&#59; LPA r&#58; arteria pulmonar izquierda de animal receptor&#59; LPV d&#58; vena pulmonar izquierda de animal donante&#59; LPV r&#58; vena pulmonar izquierda de animal receptor&#46;</p>"
        ]
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        "etiqueta" => "Figura 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
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            "imagen" => "gr3.jpeg"
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            "Tamanyo" => 157288
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        "descripcion" => array:1 [
          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Esquema de colocaci&#243;n de un manguito o <span class="elsevierStyleItalic">cuff</span> en el pulm&#243;n donante y su anastomosis en el pulm&#243;n receptor&#46;LBr d&#58; bronquio izquierdo de animal donante&#59; LBr r&#58; bronquio izquierdo de animal receptor&#59; LPA d&#58; arteria pulmonar izquierda de animal donante&#59; LPA r&#58; arteria pulmonar izquierda de animal receptor&#59; LPV d&#58; vena pulmonar izquierda de animal donante&#59; LPV r&#58; vena pulmonar izquierda de animal receptor&#46;</p>"
        ]
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      3 => array:7 [
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        "etiqueta" => "Figura 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 1592
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        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Imagen real del trasplante pulmonar realizado mediante la t&#233;cnica de <span class="elsevierStyleItalic">cuff</span> a nivel vascular y bronquial&#46;DL&#58; pulm&#243;n donante&#59; LBr r&#58; bronquio izquierdo de animal receptor&#59; LPA r&#58; arteria pulmonar izquierda de animal receptor&#59; LPV r&#58; vena pulmonar izquierda de animal receptor&#46;</p>"
        ]
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        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
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            "identificador" => "at1"
            "detalle" => "Tabla "
            "rol" => "short"
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        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " rowspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Protocolo</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Dosis &#40;mg&#47;kg&#41;</th><th class="td" title="table-head  " rowspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Duraci&#243;n &#40;min&#41;</th></tr><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Rata&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Rat&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ketamina<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>medetomidina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75-100<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>0&#44;25-0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75-150<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>0&#44;5-1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40-50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ketamina<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>xilacina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75-100<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75-150<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>12-20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40-50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ketamina<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>diacepam&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75-100<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30-40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Medetomidina<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>fentanilo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;3<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50-60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Atipamezol<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> &#40;antagonista &#945;2-adren&#233;rgico&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;5-1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;5-1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => "xTab1260383.png"
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          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">La medetomidina y la xilacina pueden antagonizarse con atipamezol&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Combinaciones anest&#233;sicas empleadas en la rata y el rat&#243;n para la realizaci&#243;n de procedimientos quir&#250;rgicos&#44; incluido el trasplante pulmonar</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabla 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Orden de anastomosis&#58; A&#58; arteria&#59; B&#58; bronquio&#59; V<span class="elsevierStyleSmallCaps">&#58;</span>vena&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">T&#233;cnica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tiempo de cirug&#237;a &#40;min&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tipo de anastomosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Orden anastomosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Longitud <span class="elsevierStyleItalic">cuff</span> &#40;mm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Di&#225;metro <span class="elsevierStyleItalic">cuff</span> &#40;mm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Supervivencia &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Sutura</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Asimacopoulos<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">6</span></a>&#44; 1971&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No descrito&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Sutura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B-A-V&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Marck<a class="elsevierStyleCrossRef" href="#bib0490"><span class="elsevierStyleSup">32</span></a>&#44; 1982&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">240&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Sutura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">V-A-B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a><br>50<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Prop<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">19</span></a>&#44; 1984&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">210<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>31y 238<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Sutura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">V-A-B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">89 y 75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Zhang<a class="elsevierStyleCrossRef" href="#bib0435"><span class="elsevierStyleSup">21</span></a>&#44; 2008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Sutura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B-A-V&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">89<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a><br>50<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Manguitos vasculares y sutura bronquial</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mizuta<a class="elsevierStyleCrossRef" href="#bib0495"><span class="elsevierStyleSup">33</span></a>&#44; 1989&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">101<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Manguito convencional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">V-A-B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;cuerpo&#58; 1&#59; leng&#252;eta&#58; 1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 y 1&#44;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Kubisa<a class="elsevierStyleCrossRef" href="#bib0500"><span class="elsevierStyleSup">34</span></a>&#44; 2003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Manguito convencional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">V-A-B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No descrito&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">96&#44;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mizobuchi<a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">35</span></a>&#44; 2004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">116<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Manguito convencional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">V-A-B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;cuerpo&#58; 2&#44;5&#59; leng&#252;eta&#58; 1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">95&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Zhai<a class="elsevierStyleCrossRef" href="#bib0510"><span class="elsevierStyleSup">36</span></a>&#44; 2008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No descrito&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Manguito modificado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">A-B-V&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;5 &#40;cuerpo&#58; 1&#59; leng&#252;eta&#58; 1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No descrito&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Habertheuer<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">30</span></a>&#44; 2013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">130<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Manguito convencional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B-A-V&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No descrito&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No descrito&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100 &#40;70-90-100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Manguitos vasculares y bronquiales</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mizuta<a class="elsevierStyleCrossRef" href="#bib0515"><span class="elsevierStyleSup">37</span></a>&#44; 1991&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">64&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No descrito&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No descrito&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No descrito&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No descrito&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">90<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Reis<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">38</span></a>&#44; 1995&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">108&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Manguito convencional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">A-V-B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;cuerpo&#58; 2&#59; leng&#252;eta&#58; 1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No descrito&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Santana Rodr&#237;guez<a class="elsevierStyleCrossRef" href="#bib0445"><span class="elsevierStyleSup">23</span></a>&#44; 2004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">110<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Manguito convencional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">V-B-A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;cuerpo&#58; 1&#44;5&#59; leng&#252;eta&#58; 1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;2 y 1&#44;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No descrito&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mizobuchi<a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">35</span></a>&#44; 2004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">84&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Manguito convencional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">V-B-A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;cuerpo&#58; 2&#44;5&#59; leng&#252;eta&#58; 1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;1 y 1&#44;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">91&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Zhai<a class="elsevierStyleCrossRef" href="#bib0510"><span class="elsevierStyleSup">36</span></a>&#44; 2008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No descrito&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Manguito modificado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">A-B-V&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;5 &#40;cuerpo&#58; 1&#59; leng&#252;eta&#58; 1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No descrito&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sugimoto<a class="elsevierStyleCrossRef" href="#bib0525"><span class="elsevierStyleSup">39</span></a>&#44; 2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">110 aprox&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No descrito&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">A-B-V&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No descrito&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No descrito&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">93&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Jungraithmayr<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">16</span></a>&#44; 2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">95&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Manguito convencional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">A-B-V&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Diferentes tama&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;64-0&#44;51-0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Santana Rodr&#237;guez<a class="elsevierStyleCrossRef" href="#bib0440"><span class="elsevierStyleSup">22</span></a>&#44; 2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">107&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Manguito convencional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">A-B-V&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;cuerpo&#58; 1&#44;5&#59; leng&#252;eta&#58; 1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">87&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Zheng<a class="elsevierStyleCrossRef" href="#bib0545"><span class="elsevierStyleSup">43</span></a>&#44; 2013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">96&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Manguito convencional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">A-V-B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Diferentes tama&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;81-0&#44;64-0&#44;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">96&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Zheng<a class="elsevierStyleCrossRef" href="#bib0545"><span class="elsevierStyleSup">43</span></a>&#44; 2013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Manguito modificado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">A-V-B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No descrito&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;81-0&#44;64-0&#44;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Autor y a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Especie&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sexo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cepas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Modelo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Objetivo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Aeba et al&#46;<a class="elsevierStyleCrossRef" href="#bib0575"><span class="elsevierStyleSup">49</span></a>&#44; 1992&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rata&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Machos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Lewis &#40;donante y receptor&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Trasplante pulmonar ortot&#243;pico izquierdo tras 6 o 12<span class="elsevierStyleHsp" style=""></span>h de isquemia fr&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Comparaci&#243;n de diferentes soluciones de preservaci&#243;n pulmonar &#40;Wisconsin y Euro-Collins&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Zweers et al&#46;<a class="elsevierStyleCrossRef" href="#bib0565"><span class="elsevierStyleSup">47</span></a>&#44; 2004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rata&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Machos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Fisher 344 &#40;donante&#41;&#59; Wistar Kyoto WKY &#40;receptor&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Trasplante pulmonar ortot&#243;pico izquierdo con la t&#233;cnica de sutura convencional e inducci&#243;n de muerte cerebral en el donante durante 6<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Estudio del efecto de la muerte cerebral en el rechazo cr&#243;nico tras el trasplante pulmonar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Okazaki et al&#46;<a class="elsevierStyleCrossRef" href="#bib0620"><span class="elsevierStyleSup">58</span></a>&#44; 2007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rat&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Machos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">BALB&#47;c&#44; C57BL&#47;6 &#40;B6&#41;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a> &#40;donante&#41;&#59; B6 &#40;receptor&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Trasplante pulmonar ortot&#243;pico izquierdo con la t&#233;cnica de <span class="elsevierStyleItalic">cuff</span> y trasplante heterot&#243;pico de tr&#225;quea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Comparativa del trasplante de tr&#225;quea y trasplante pulmonar en el estudio del rechazo agudo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Greschus et al&#46;<a class="elsevierStyleCrossRef" href="#bib0595"><span class="elsevierStyleSup">53</span></a>&#44; 2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rata&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Machos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F344&#44; Dark Agouti&#44; WKY &#40;donantes&#41;&#59; WKY&#44; Lewis&#44; F344&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Trasplante pulmonar ortot&#243;pico izquierdo con la t&#233;cnica de <span class="elsevierStyleItalic">cuff</span> vascular y sutura bronquial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Monitorizaci&#243;n y evaluaci&#243;n del pulm&#243;n trasplantado mediante tomograf&#237;a volum&#233;trica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Santana-Rodr&#237;guez et al&#46;<a class="elsevierStyleCrossRef" href="#bib0590"><span class="elsevierStyleSup">52</span></a>&#44; 2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rata&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Machos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Sprague-Dawley &#40;donante y receptor&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Trasplante pulmonar ortot&#243;pico izquierdo con la t&#233;cnica de cuff</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Evaluaci&#243;n del efecto del estradiol en la lesi&#243;n pulmonar por isquemia-reperfusi&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Santana Rodr&#237;guez et al&#46;<a class="elsevierStyleCrossRef" href="#bib0440"><span class="elsevierStyleSup">22</span></a>&#44; 2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rata&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Machos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Sprague-Dawley &#40;donante y receptor&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Trasplante pulmonar ortot&#243;pico izquierdo con la t&#233;cnica de <span class="elsevierStyleItalic">cuff</span> e inducci&#243;n de muerte cerebral en el donante&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Evaluaci&#243;n de la permeabilidad de las anastomosis y de los signos de lesi&#243;n por isquemia-reperfusi&#243;n similares al rechazo agudo en 2 modelos t&#233;cnicos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Kreisel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0580"><span class="elsevierStyleSup">50</span></a>&#44; 2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rat&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Machos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Balb&#47;c&#44; B6&#44; B10&#46;BR CD11c-EYFP &#40;donante&#41;&#59; B6 LysM-GFP&#44; B6 TNF-&#945;<span class="elsevierStyleSup">&#8722;&#47;&#8722;</span> &#40;receptor&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Trasplante pulmonar ortot&#243;pico izquierdo con la t&#233;cnica de <span class="elsevierStyleItalic">cuff</span> tras 1 y 18<span class="elsevierStyleHsp" style=""></span>h de isquemia fr&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Estudio de la disfunci&#243;n primaria del injerto por isquemia-reperfusi&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Kreisel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0585"><span class="elsevierStyleSup">51</span></a>&#44; 2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rat&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Machos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B6 &#40;donante&#41;-B6 &#40;B6&#41;&#44; B6 &#40;Bcl3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Trasplante pulmonar ortot&#243;pico izquierdo con la t&#233;cnica de cuff</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Estudio del factor transcripcional Bcl3 y su relaci&#243;n con el rechazo agudo tras el trasplante pulmonar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dodd-o et al&#46;<a class="elsevierStyleCrossRef" href="#bib0625"><span class="elsevierStyleSup">59</span></a>&#44; 2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rat&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Machos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B6&#44; BALB&#47;c &#40;donante&#41;&#59; B6 &#40;receptor&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Trasplante pulmonar ortot&#243;pico izquierdo con la t&#233;cnica de cuff</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Estudio de la atenuaci&#243;n del rechazo agudo mediante el uso de anticuerpos anti-CD-154&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Jungraithmayr et al&#46;<a class="elsevierStyleCrossRef" href="#bib0605"><span class="elsevierStyleSup">55</span></a>&#44; 2012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rat&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Machos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">BALB&#47;c &#40;H-2Kd&#41; &#40;donante&#41;&#59; B6 &#40;receptor&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Trasplante pulmonar ortot&#243;pico izquierdo con la t&#233;cnica de cuff</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Evaluaci&#243;n y estudio del rechazo agudo mediante microscopia electr&#243;nica de barrido&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Santana-Rodr&#237;guez et al&#46;<a class="elsevierStyleCrossRef" href="#bib0660"><span class="elsevierStyleSup">66</span></a>&#44; 2012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rata&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Machos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Sprague-Dawley &#40;donante y receptor&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Trasplante pulmonar ortot&#243;pico izquierdo con la t&#233;cnica de cuff</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Evaluaci&#243;n del rechazo agudo en el trasplante pulmonar mediante el estudio de microarrays de ADN&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0615"><span class="elsevierStyleSup">57</span></a>&#44; 2013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rat&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Machos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B6&#44; BALB&#47;c &#40;donante&#41;&#59; B6 &#40;receptor&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Trasplante pulmonar ortot&#243;pico izquierdo con la t&#233;cnica de cuff</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Identificaci&#243;n del rechazo agudo mediante el estudio del metabolismo de las c&#233;lulas T con t&#233;cnicas de imagen &#40;microtomograf&#237;a de emisi&#243;n de positrones&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Erne et al&#46;<a class="elsevierStyleCrossRef" href="#bib0640"><span class="elsevierStyleSup">62</span></a>&#44; 2013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rata&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Machos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Brown-Norway &#40;donante&#41;&#59; Lewis &#40;receptor&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Trasplante pulmonar ortot&#243;pico izquierdo con la t&#233;cnica de cuff</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Atenuaci&#243;n del rechazo pulmonar agudo mediante la administraci&#243;n de N-acetilciste&#237;na&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tanaka et al&#46;<a class="elsevierStyleCrossRef" href="#bib0460"><span class="elsevierStyleSup">26</span></a>&#44; 2014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rata&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Machos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Lewis &#40;donante y receptor&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Trasplante pulmonar ortot&#243;pico izquierdo con la t&#233;cnica de <span class="elsevierStyleItalic">cuff</span> tras 6<span class="elsevierStyleHsp" style=""></span>h de preservaci&#243;n a distintos porcentajes de inflado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Evaluaci&#243;n del efecto de inflado de los pulmones donantes durante la preservaci&#243;n pulmonar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Takahashi et al&#46;<a class="elsevierStyleCrossRef" href="#bib0610"><span class="elsevierStyleSup">56</span></a>&#44; 2014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rata&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Machos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Brown-Norway &#40;BN&#41; &#40;donante&#41;&#59; BN&#44; Lewis &#40;receptor&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Trasplante pulmonar ortot&#243;pico izquierdo con la t&#233;cnica de cuff</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Estudio de la funci&#243;n pulmonar en el rechazo agudo mediante t&#233;cnicas no invasivas como la oscilaci&#243;n forzada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Kreisel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0635"><span class="elsevierStyleSup">61</span></a>&#44; 2010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rat&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Machos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B6<span class="elsevierStyleSup">CD45&#46;1</span>&#44; B6II<span class="elsevierStyleSup">&#8722;</span> &#40;donante&#41;&#59; B6&#44; B6Rag<span class="elsevierStyleSup">-&#47;-</span>&#44; B6&#47;B6II<span class="elsevierStyleSup">&#8722;</span> F1 &#40;receptor&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Trasplante pulmonar ortot&#243;pico izquierdo con la t&#233;cnica de <span class="elsevierStyleItalic">cuff</span>&#44; as&#237; como de m&#233;dula &#243;sea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Estudio del efecto de las c&#233;lulas pulmonares no hematopoy&#233;ticas y su acci&#243;n sobre las c&#233;lulas T CD4&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Zhou et al&#46;<a class="elsevierStyleCrossRef" href="#bib0630"><span class="elsevierStyleSup">60</span></a>&#44; 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rat&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Machos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B6&#44; BALB&#47;c &#40;donante&#41;&#59; B6 &#40;receptor&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Trasplante pulmonar ortot&#243;pico izquierdo con la t&#233;cnica de cuff</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Relaci&#243;n entre el rechazo agudo y la producci&#243;n de IL-17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Raissadati et al&#46;<a class="elsevierStyleCrossRef" href="#bib0645"><span class="elsevierStyleSup">63</span></a>&#44; 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rat&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Machos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">BALB&#47;c &#40;donante&#41;&#59; B6&#40;receptor&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Trasplante heterot&#243;pico de tr&#225;quea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Estudio del efecto de la prote&#237;na CCN1 en un modelo de bronquiolitis obliterante&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Wu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0650"><span class="elsevierStyleSup">64</span></a>&#44; 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rat&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Machos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">C57Bl&#47;10&#44; B6 &#40;donante&#41;&#59; B6 &#40;receptor&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Trasplante pulmonar ortot&#243;pico izquierdo con la t&#233;cnica de cuff</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Estudio de la influencia de las c&#233;lulas T CD4&#43; y la producci&#243;n de IL-17 en un modelo de bronquiolitis obliterante&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chuck et al&#46;<a class="elsevierStyleCrossRef" href="#bib0600"><span class="elsevierStyleSup">54</span></a>&#44; 2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rat&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Machos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B6&#44; BALB&#47;c &#40;H-2Kd&#41; &#40;donante&#41;&#59; B6 &#40;receptor&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Trasplante pulmonar ortot&#243;pico izquierdo con la t&#233;cnica de cuff</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Evaluaci&#243;n de los cambios producidos en el pulm&#243;n trasplantado por el rechazo agudo y lesi&#243;n por isquemia-reperfusi&#243;n mediante resonancia magn&#233;tica ultracorta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Resumen de los principales aspectos evaluados mediante modelos murinos de trasplante pulmonar</p>"
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