无心跳供体供肺的低温保存

Cryopreservation of the lung from a non-hear-beating donor

背景:目前无心跳供体供肺原位低温保护实现的途径主要有2种,一种是胸腔内表面降温技术,这种方法已经被临床成功的移植证实有效,一种是气管内通气降温技术。目的:探讨大鼠无心跳供肺移植模型中原位支气管内通气降温和胸腔内表面降温技术结合实现低温保存供肺的可行性。方法:将无心跳供肺移植Wistar大鼠模型随机分为:通气组以低温气体吹入气管降温,表面组双侧胸腔置管连续注入低温生理盐水,结合组同时行低温气体通气和低温盐水胸腔内降温。结果与结论:结合组降温效果强于表面组和通气组(P<0.05),可在60min内将气管内、肺实质和胸腔内温度降到保存温度。初步证明原位支气管内通气降温和胸腔内表面降温技术结合降温的方式在肺移植中应用的可行性。

BACKGROUND： There are two ways to cryopreserve the lung from non-heart-beating donors： one is in situ thoracic cavity internal surface cooling technique, which has been confirmed by successful transplantation in the clinic, and the other is in situ endotracheal venting cooling technique. OBJECTIVE： To evaluate the feasibility of combining in situ thoracic cavity internal surface cooling technique with in situ endotracheal venting cooling technique in cryopreserving the lung from non-heart-beating donor. METHODS： Wister rats were randomly divided into three groups： in situ endotracheal venting hypothermy group （venting group）, cool gas was insufflated into the trachea; in situ thoracic cavity internal surface hypothermy group （surface group）： cool physiological saline was persistently injected into bilateral thoracic cavity; and combination group： cool gas insufflation combined with physiological saline injection into bilateral thoracic cavities RESULTS AND CONCLUSION： The combination group produced better effects than the surface group and venting group （P 〈 0.05）, and the temperature of trachea and lung parenchyma could be lowered to preservation temperature within 60 minutes. These findings suggest the feasibility of in situ thoracic cavity internal surface cooling technique and in situ endotracheal venting cooling technique used in lung transplantation.