含血棉子糖低钾右旋糖酐液在大鼠离体肺低温静态保存中的作用

The role of raffinose-low potassium dextran lung preservation solution with blood in pulmonary graft preservation

目的探讨含血棉子糖低钾右旋糖酐液（R-LPD液）在大鼠离体肺静态低温保存中的作用。方法健康雄性SD大鼠50只，采用随机数字表法分为R-LPD液灌注保存组（对照组）和含血R-LPD液灌注保存组（实验组），每组25只。灌注完成后，使双肺保持半膨胀状态，同时夹闭两侧肺门，保持灌注液在肺血管中充盈，切取整个肺置于灌注液中，于4℃冰箱中保存。于保存即刻（0）、2、4、6、8、10、12、14、16、24h等时间点取大鼠肺组织样本。观察肺湿干重比，HE染色观察肺水肿、炎症浸润等病理改变，免疫组织化学法检测Cleaved Caspase-3表达水平。结果保存4～10h时，实验组肺组织的湿干重比值显著低于对照组（P〈0．05）；保存10～12h时，炎症浸润程度低于对照组；免疫组织化学检测结果显示，保存10-14h时实验组肺组织Cleaved Caspase-3的表达水平显著低于对照组（P〈0．05）。结论含血R-LPD液对大鼠离体肺具有保护作用，其机制可能与减轻肺水肿和炎症浸润及抑制凋亡蛋白Cleaved Caspase-3表达相关。

Objective To investigate the potential of a novel preservation solution, raffinose-low potassium dextran lung preservation solution with blood （BR-LPDS） in the preservation of the isolated lungs in rats,when compared to low-potassium dextran solution （LPDS）. Methods Fifty donor lungs of Sprague-Dawley rats were randomly flushed with either R-LPDS （R-LPDS group, n = 25） or R- LPDS modified by the addition of blood （BR-LPDS group,n = 25）. After reperfusion, the double lungs were kept half inflate and then the pulmonary artery and bronchus were clamped. Then the grafts were flushed with and submerged in cold preservation solution at 4 C for 24 h. And they were excised for measurement of wet-to-dry ratio, as well as histologic examination to evaluate pulmonary edema, inflammation and cleaved caspase-3 expression at 0, 2, 4, 5, 6, 8, 10, 12, 14, 16, 24 h. Results As compared with the R-LPDS group, the mean wet-to-dry ratio of lungs in the BR-LPDS group was significantly reduced from 4 to 10 h after reperfusion. Upon histologic examination, less inflammatory cell aggregates and lower caspase-3 activity were seen in the lungs of the BR-LPDS group from 10 to 12 h and 10 to 14 h after reperfusion, respectively. Conclusion The addition of blood to the R-LPDS solution was shown to be more effective in reducing swelling, inflammation and caspase-3 expression of donor lungs than the R-LPDS solution. Further investigation is needed to evaluate lung preservation in BR-LPD solution as a viable option for transplant.