改良自制低钾右旋糖酐液用于犬肺移植肺保存质量的观察

Quality of lung preserved with modified self-confected low potassium dextran solution in canine lung transplantation

目的探讨改良自制低钾右旋糖酐液(LPD液)的配制方法及对移植肺的保存质量。方法参照Per-fadex液公开配方加入前列腺素E1(PGE1)和硝酸甘油(NTG)进行改良,自行配制LPD液。于2007年4月至2008年8月通过动物实验验证LPD液对移植肺的保存质量。32只家犬随机分成供体组和受体组,每组16只。完成16次左单肺移植,8次采用Perfadex液作为灌注保存液,为对照组;另8次采用改良自制LPD液,为实验组。比较实验组和对照组2组供肺组织灌注前、灌注后、保存4h、8h、12h、24h及移植后4h的髓过氧化物酶(MPO)、丙二醛(MDA)、湿干比(W/D)及光镜、透射电镜结果;比较移植前后2组活体肺循环血管阻力(PVR)、肺顺应性和机体氧合参数的变化。结果改良自制LPD液与Perfadex液的成分及理化特点相近。2组MPO、MDA、W/D、PVR、肺顺应性及机体氧合状态等参数在各时间点均无显著性差异(P>0.05);肺组织光镜下结构及透射电镜下超微结构的变化于各时间点无显著性差异(P>0.05),但实验组变化略轻。结论改良自制LPD液的配制方法简便可行,可以达到与Perfadex液相近的供肺灌注保存效果。

Objective To confect the modified self-confected low potassium dextran solution（LPD solution） and compare the effectiveness of lung preservation between modified self-confected LPD solution and Perfadex solution in canine left single lung transplantation model.Methods Self-confected LPD solution was confected based on the public prescription of Perfadex solution.The modification was carried out by adding up PGE1 and NTG.Thirty-two dogs were divided into two groups randomly.Sixteen left single lung transplantations in situ were performed and also divided into two groups in which the control group were flushed with Perfadex solution,while the experimental group were flushed with modified self-confected LPD solution.In vivo,changes of MPO,MDA,W/D,pathological results and super-micro-structural results from pre-flush,after flush,4-8-12-24h of preservation and 4h after transplantation were compared,respectively.In vitro,changes of pulmonary vascular resistance,pulmonary conformance and systemic oxygen supplement were also compared,respectively.Results The physicochemical property of modified self-confected LPD solution was close to Perfadex solution.No significant difference was found between the two groups either in the changes of MPO,MDA,W/D,pathological results and super-micro structural results,nor in the changes of pulmonary vascular resistance,pulmonary conformance and systemic oxygen supplement（P 0.05）.But the changes of pathological results and super-micro structural results from the experimental group were slightly less than those of the control group.Conclusions Modified self-confected LPD solution is simple and easily accessible.The effectiveness of lung preservation with modified self-confected LPD solution is similar to Perfadex solution.