LPD液对无心跳供体肺的保护作用

Histopathological investigation of protective effects of low potassium dextran glucose solution on non-heart-beating donor lungs

目的从肺组织病理学角度,评价低钾右旋糖酐(LPD)液对无心跳供体(NHBD)肺的保护作用。方法左侧供体肺使用 LPD 液采用顺行和逆行灌注技术。对在4℃灌注液中保存6、12、18、24 h 和缺血-再灌注1 h 的标本行组织病理学检查。结果随着冷保存时间的延长,供体肺组织病理变化并不明显。仅12、18和24 h 组可见灶状肺泡萎陷;缺血-再灌注组的肺小动脉及血管内充血,部分肺泡壁血管充血伴周围炎性细胞渗出。结论 LPD 液可以安全的应用于临床尸体肺移植术。LPD 液优良的保存效果使其可以扩大供体肺的数量和延长供体肺的安全缺血时限。

Objective The aim of this study was to observe the pathological changes in lungs perfused with the low potassium dextran glucose （LPD） solution at 4℃ in preservation of the non-heart-beating donor （NHBD） lung in lung transplantation LTx, and to assess the protective effects of IPDS in LTx of NHBD. Methods The warm ischemic time was 7 to 10 minutes respectively for cadaveric LTx, the lungs were perfused either antegradely or retrogradely with IPD. Lamgs biopsies were perfomaed before cold ischaemic storage at 4℃ for 6h, 12h, 18h, 24h respectively and 1 h after reperfusion Histogathological changes of the lungs were observed during ischemia and repeffusion, Results The histolopathdogic examination on all groups revealed almost normal lung structure without alveolar wall thickev.ing or edema, the small bronchi structure and epithelial cell was almost normal without intra-alveolar hemorrhage. Only slight to mild infiltration of the inflammstory cells and macrophagus was seen in the alveolar wall or alveolar space or alveoli of lung were collapsed during cold ischaemic storage at 4℃ for 12 h, 18 h,24 h. After repeffusion alveolar capillaries were engorge, miM infiltration of the inflammatory cells and minimal interstitial edematous was seen in the perivascular. Conclusion LPD solution may be safely applied in clinical eadaveric LTx with extended donor lungs ischemic times because of its excellent preservation ability.