热缺血供体同种异体犬肺移植术后早期肺功能的观察

Early lung function after non-heart-beating-donor allo-transplantation in an canine model

目的 观察犬热缺血供体同种异体肺移植术后早期移植肺功能情况。方法 采用室温下热缺血 3 0min、LPD液灌注后 4℃保存 2 5h时的供肺 ,行右肺同种异体移植手术 7例 ,术前及监测恢复灌注 0 5 ,1,2及 4h的动脉血氧分压 (PaO2 )、肺动态顺应性 (Cdyn)、平均肺动脉压 (mPAP)、肺毛细血管楔压 (PCWP)和心输出量的变化 (CO)。结果 所有受体犬在观察期间均存活。恢复灌注 4h内的肺功能各指标变化差异无显著性 (P >0 0 5 ) ,或者虽然有统计学差异 ,但仍有较好的绝对水平。结论 热缺血 3 0min低温保存 2 5h的供肺可以维持生命 ,恢复灌注后 ,受缺血再灌注损伤的影响 ,在灌注后一段时间内 ,供肺功能下降 ,但仍可较好支持生命。

Objective To investigate the early lung function after non-heart-beating-donor allo-transplantation in a canine in-situ model. Methods After warm ischemia for 30 minutes, donor lungs were flushed with cold low-potassium dextran glucose solution followed with 2.5 hours of hypothermia storage. Seven right lung allotransplantation procedures were subsequently performed. Function of each donor lung at baseline and at 0.5 hour, 1 hour, 2 hours, 4 hours after operation was assessed including: PaO 2, Cdyn,PAP, PCWP, and CO. Results All recipient dogs survived during the investigating period. Most lung functions didnot change significantly during the investigating period. Some had good absolute level though changed significantly. Conclusion The function of donor lung flushed by LPD solution after warm ischemia for 30 minutes followed with cold storage for 2.5 hours is enough to keep recipient alive from the beginning of reperfusion to 240 minutes after operation, although lung function decreases because of ischemia reperfusion injury.