缺血预处理对犬移植肺保存效果的研究

EFFECTS OF ISCHEMIC PRECONDITIONING ON PROTECTION OF CANINE DONOR LUNG

１２次犬异体左肺移植随机分为冷Ｅｕｒｏ－Ｃｏｌｉｎｓ液（ＥＣＳ）组（ｎ＝６）和缺血预处理＋ＥＣＳ组（ｎ＝６）。缺血预处理采用阻断供体左肺门１０ｍｉｎ，再开放１５ｍｉｎ的方法。供肺冷灌采取后４℃保存。移植后观察２ｈ。结果显示：缺血预处理组有较高的氧分压和较低的平均肺动脉压（Ｐ＜０．０５），肺组织光镜显示较轻的肺损伤。表明缺血预处理结合４℃ＥＣＳ灌洗优于单独４℃ＥＣＳ的保护效果。

The authors examined the effects of ischemic preconditioning on lung preservation using a canine single left lung transplantation. Twelve adult mongrel dogs underwent left lung allotransplantation. Donor lungs were perfused and flushed with cold Euro Collins solution (ECS) and stored at 4℃ ECS for 2 hours. Six donors were preconditioned by occuluding left lung hilum for 10 minutes and releasing for 15 minutes before flushing (Group PC); other six donors without ischemic preconditioning served as the controls (Group C). Left inferior pulmonary vein blood gas analysis, mean pulmonary artery pressure measurement and donor lung histology examination were made to evaluate the function of transplanted lung after transplantation. Oxygen tension at 2 hrs after reperfusion were significantly better in Group PC than in Group C (431±130 mmHg vs 246±66 mmHg, P<0.05); mean pulmonary artery pressure was much lower in Group PC than in Group C after reperfusion (20.6±1.3mmHg vs 36.9±3.1mmHg, P<0.01). Histological findings showed less injury in Group PC. These indicate that ischemic preconditioning combined with cold ECS perfusion is superior to cold ECS perfusion alone in canine lung preservation of 3 hours ischemia with 2 hours reperfusion.