AIM： To investigate the relationship between donor liver cold preservation, lung surfactant （LS） changes and acute lung injury （ALI） after liver transplantation. METHODS： Liver transplantation models were estab-...AIM： To investigate the relationship between donor liver cold preservation, lung surfactant （LS） changes and acute lung injury （ALI） after liver transplantation. METHODS： Liver transplantation models were estab- lished using male Wistar rats. Donor livers were pre- served in University of Wisconsin solution at 4 ℃ for different lengths of time. The effect of ammonium pyr- rolidinedithiocarbamate （PDTC） on ALI was also detect- ed. All samples were harvested after 3 h reperfusion.The severity of AU was evaluated by lung weight/body weight ratio, lung histopathological score, serum nitric oxide （NO） and endothelin （ET）-I levels, lung tumor necrosis factor （TNF）-α and interleukin （IL）-1β levels. Lung surfactants （LSs） were determined by micellar electrokinetic capillary chromatography. RESULTS： With extended donor liver cold preservation time （CPT）, lung histopathological scores, serum ET-i levels, lung weight/body weight ratio and the level of TNF-α and IL-1β in lung were increased significantly in the 180-min group compared with the sham group （3.16± 0.28 vs 1.12 ± 0.21, P 〈 0.001; 343.59±53.97 vs 141.53± 48.48, P 〈 0.001; 0.00687 ±0.00037 vs 0.00557 ±0.00056, P 〈 0.001; 17.5 ± 3.0 vs 1,3 ± 0.3, P 〈 0.001; 10.8± 2.3 vs 1.8 ± 0.4, P 〈 0.001）, but serum NO levels decreased remarkably （74.67 ± 10.01 vs 24.97 ± 3.18, P 〈 0.001）. The expression of lung phos- phatidylcholine （PC）, phosphatidylethanolamine （PE）, phosphatidylinositol （PI） and phosphatidylserine （PS） increased when CPT was 〈 120 rain, and decreased when CPT was 〉 180 min （PC： 1318.89 ± 54.79 vs 1011.18± 59.99, P 〈 0.001; PE： 1504.45± 119.96 vs 1340.80±76.39, P = 0.0019; PI： 201.23 ± 34.82 vs 185.88 ± 17.04, P = 0.2265; PS： 300.43±32.95 vs 286.55± 55.55, P = 0.5054）. All these ALI-associated indexes could be partially reversed by PDTC treatment.展开更多
Objective To summarize preservation measures of donor’s heart and lung,and postoperative imrnunotherapy,as well as clinical experience of discrimination and management for graft rejection. Methods Clinical data of 2 ...Objective To summarize preservation measures of donor’s heart and lung,and postoperative imrnunotherapy,as well as clinical experience of discrimination and management for graft rejection. Methods Clinical data of 2 cases of heart - lung transplantation in our depart-展开更多
Objective To determine the effects of prostaglandin El (PGEl ) on the pulmonary bind flow by using retrograde flush (RF) in lung preservation. Methods Twelve canine donor lungs were treated with RF with UW solution. ...Objective To determine the effects of prostaglandin El (PGEl ) on the pulmonary bind flow by using retrograde flush (RF) in lung preservation. Methods Twelve canine donor lungs were treated with RF with UW solution. In group A (n = 6 ), 250μg of PGE1 wes infused into the pulmonary artery (PA ) before RF and another 250μg wes mixed with UW solution. No PGE1 wes used in group B (n = 6 ). After storage in the mine solution at 4℃ for 22 ~ 25h, the left lung wus transplanted to a recipient followed by 120min reperfusion. Pulmonary bind flow was determined by a microsphere technique. Colored microspheres were infused into the right atrium at the following time: before RF and donor lungs procurement (red ), prior to resecting the recipient left lung (red, served as vaseline), and 120min after donor lung implantation (yellow). Micro- sphere distribution was expressed by optical density per gram lung tissue (OD/g). Results The red microsphere distribution after transplantation in group A wus reduced as compered with baseline (P < 0. 05 ). And more bind flew to the right lung (P < 0. 05 ). The yellow microsphere distribution was also significantly reduced in group A when compered with that of group B (P < 0. 01 ). The hemodynamic bata and bind gases for the two groups were not significantly different. Conclusion After single left lung transplantation, more bind flows to the right side. Pretreatment with PGEl further reduces the flow distribution in the left side.展开更多
Background The composition of the lung preservation solution used in lung graft procurement has been considered the key to minimize lung injury during the period of ischemia. Low-potassium dextran glucose （LPDG）, an...Background The composition of the lung preservation solution used in lung graft procurement has been considered the key to minimize lung injury during the period of ischemia. Low-potassium dextran glucose （LPDG）, an extracellular-type solution, has been adopted by most lung transplantation centers, due to the experimental and clinical evidences that LPDG is superior to intracellular-type solutions. Ulinastatin has been shown to attenuate ischemia-reperfusion （I/R） injury in various organs in animals. We supposed that the addition of ulinastatin to LPDG as a flushing solution, would further ameliorate I/R lung injury than LPDG solution alone.Methods Twelve male New Zealand white rabbits were randomly divided into 2 groups. Using an alternative in situ lung I/R model, the left lung in the control group was supplied and preserved with LPDG solution for 120 minutes. In the study group 50 000 U/kg of ulinastatin was added to the LPDG solution for lung preservation. Then re-ventilation and reperfusion of the left lung were performed for 90 minutes. Blood gas analysis （PaO2, PaCO2）, mean pulmonary artery pressure （MPAP） and serum TNF-α level were measured intermittently. The pulmonary water index （D/W）, tissue myeloperoxidase （MPO） activity, tissue malondialdehyde （MDA） content and morphologic changes were analyzed.Results The study group showed significantly higher PaO2 and lower MPAP at the end of reperfusion. Serum TNF-α level, left lung tissue MPO and MDA in the study group were significantly lower than those in the control group. D/W and pathologic evaluation were also remarkably different between the two groups.Conclusions This study indicated that better lung preservation could be achieved with the use of an ulinastatin modified LPDG solution. Ulinastatin further attenuated lung I/R injury, at least partly by reducing oxidative reactions,inhibiting the release of inflammatory factors and neutrophils immigration.展开更多
OBJECTIVE: To test the validity of continuous low-flow perfusion with low-potassium dextran (LPD) to preserve rabbit lung. METHODS: Isolated rabbit lungs were preserved for eight hours either in Ringer's solution ...OBJECTIVE: To test the validity of continuous low-flow perfusion with low-potassium dextran (LPD) to preserve rabbit lung. METHODS: Isolated rabbit lungs were preserved for eight hours either in Ringer's solution by simple storage (Group I) or in continuous low-flow perfusion with LPD (Group II). After preservation, lung functions were assessed to compare these two methods. RESULTS: The water gain in Group I was higher than that in Group II. During reperfusion, the functional test values for the immersed lungs were lower than those for the perfused lungs. The lipid peroxidation product (MDA) was significantly decreased in perfused lungs during reperfusion. CONCLUSIONS: Low-flow perfusion with LPD is better than immersion for the lung preservation.展开更多
Methods Ten pairs of adult canines underwent left lung allotransplantation. Five donors were treated with ischemic preconditioning [their left hilus was clamped for 10 minutes and released for 15 minutes (Group IP)],...Methods Ten pairs of adult canines underwent left lung allotransplantation. Five donors were treated with ischemic preconditioning [their left hilus was clamped for 10 minutes and released for 15 minutes (Group IP)], and five donors were not treated with ischemic preconditioning (Group C). The donor lungs were flushed with 4℃ Euro Collin's solution (ECS) and stored in the same solution for two and a half hour, then transplanted to the recipient canines, who were observed for one to two hours after transplantation. The lung venous blood of the recipient and the donor lung tissue were collected just after thoracotomy and one hour after reperfusion of the transplanted lung in both groups. Results The number of polymorphonuclear (PMN) was significantly higher in Group IP than in Group C (P<0.05). However, the number of PMN in lung interstitium under microscope was less in Group IP than in Group C. The thromboxane (TXB 2), malondialdehyde (MDA) and mean pulmonary artery pressure (MPAP) contents were significantly lower in Group IP than in Group C (P<0.05). The superoxide dismutase (SOD) and the lung venous blood oxygen tension (PvO 2) contents were significantly higher in Group IP than in Group C (P<0.05). Histological findings showed less damages in Group IP than in Group C. Conclusions The protective effect of ischemic preconditioning together with ECS flush and storage is superior to using ECS alone. The possible mechanisms may be that ischemic preconditioning inhibits the accumulation and activation of PMN in lung tissue and reduces the production of oxygen free radicals.展开更多
基金Supported by Grants from the National Natural Science Foundation of China,No.30200269Science and technology projects in Shannxi Province,No.2006k12-G3(6)Science and technology projects in Xi’an city,No.SF1025(3)
文摘AIM： To investigate the relationship between donor liver cold preservation, lung surfactant （LS） changes and acute lung injury （ALI） after liver transplantation. METHODS： Liver transplantation models were estab- lished using male Wistar rats. Donor livers were pre- served in University of Wisconsin solution at 4 ℃ for different lengths of time. The effect of ammonium pyr- rolidinedithiocarbamate （PDTC） on ALI was also detect- ed. All samples were harvested after 3 h reperfusion.The severity of AU was evaluated by lung weight/body weight ratio, lung histopathological score, serum nitric oxide （NO） and endothelin （ET）-I levels, lung tumor necrosis factor （TNF）-α and interleukin （IL）-1β levels. Lung surfactants （LSs） were determined by micellar electrokinetic capillary chromatography. RESULTS： With extended donor liver cold preservation time （CPT）, lung histopathological scores, serum ET-i levels, lung weight/body weight ratio and the level of TNF-α and IL-1β in lung were increased significantly in the 180-min group compared with the sham group （3.16± 0.28 vs 1.12 ± 0.21, P 〈 0.001; 343.59±53.97 vs 141.53± 48.48, P 〈 0.001; 0.00687 ±0.00037 vs 0.00557 ±0.00056, P 〈 0.001; 17.5 ± 3.0 vs 1,3 ± 0.3, P 〈 0.001; 10.8± 2.3 vs 1.8 ± 0.4, P 〈 0.001）, but serum NO levels decreased remarkably （74.67 ± 10.01 vs 24.97 ± 3.18, P 〈 0.001）. The expression of lung phos- phatidylcholine （PC）, phosphatidylethanolamine （PE）, phosphatidylinositol （PI） and phosphatidylserine （PS） increased when CPT was 〈 120 rain, and decreased when CPT was 〉 180 min （PC： 1318.89 ± 54.79 vs 1011.18± 59.99, P 〈 0.001; PE： 1504.45± 119.96 vs 1340.80±76.39, P = 0.0019; PI： 201.23 ± 34.82 vs 185.88 ± 17.04, P = 0.2265; PS： 300.43±32.95 vs 286.55± 55.55, P = 0.5054）. All these ALI-associated indexes could be partially reversed by PDTC treatment.
文摘Objective To summarize preservation measures of donor’s heart and lung,and postoperative imrnunotherapy,as well as clinical experience of discrimination and management for graft rejection. Methods Clinical data of 2 cases of heart - lung transplantation in our depart-
文摘Objective To determine the effects of prostaglandin El (PGEl ) on the pulmonary bind flow by using retrograde flush (RF) in lung preservation. Methods Twelve canine donor lungs were treated with RF with UW solution. In group A (n = 6 ), 250μg of PGE1 wes infused into the pulmonary artery (PA ) before RF and another 250μg wes mixed with UW solution. No PGE1 wes used in group B (n = 6 ). After storage in the mine solution at 4℃ for 22 ~ 25h, the left lung wus transplanted to a recipient followed by 120min reperfusion. Pulmonary bind flow was determined by a microsphere technique. Colored microspheres were infused into the right atrium at the following time: before RF and donor lungs procurement (red ), prior to resecting the recipient left lung (red, served as vaseline), and 120min after donor lung implantation (yellow). Micro- sphere distribution was expressed by optical density per gram lung tissue (OD/g). Results The red microsphere distribution after transplantation in group A wus reduced as compered with baseline (P < 0. 05 ). And more bind flew to the right lung (P < 0. 05 ). The yellow microsphere distribution was also significantly reduced in group A when compered with that of group B (P < 0. 01 ). The hemodynamic bata and bind gases for the two groups were not significantly different. Conclusion After single left lung transplantation, more bind flows to the right side. Pretreatment with PGEl further reduces the flow distribution in the left side.
文摘Background The composition of the lung preservation solution used in lung graft procurement has been considered the key to minimize lung injury during the period of ischemia. Low-potassium dextran glucose （LPDG）, an extracellular-type solution, has been adopted by most lung transplantation centers, due to the experimental and clinical evidences that LPDG is superior to intracellular-type solutions. Ulinastatin has been shown to attenuate ischemia-reperfusion （I/R） injury in various organs in animals. We supposed that the addition of ulinastatin to LPDG as a flushing solution, would further ameliorate I/R lung injury than LPDG solution alone.Methods Twelve male New Zealand white rabbits were randomly divided into 2 groups. Using an alternative in situ lung I/R model, the left lung in the control group was supplied and preserved with LPDG solution for 120 minutes. In the study group 50 000 U/kg of ulinastatin was added to the LPDG solution for lung preservation. Then re-ventilation and reperfusion of the left lung were performed for 90 minutes. Blood gas analysis （PaO2, PaCO2）, mean pulmonary artery pressure （MPAP） and serum TNF-α level were measured intermittently. The pulmonary water index （D/W）, tissue myeloperoxidase （MPO） activity, tissue malondialdehyde （MDA） content and morphologic changes were analyzed.Results The study group showed significantly higher PaO2 and lower MPAP at the end of reperfusion. Serum TNF-α level, left lung tissue MPO and MDA in the study group were significantly lower than those in the control group. D/W and pathologic evaluation were also remarkably different between the two groups.Conclusions This study indicated that better lung preservation could be achieved with the use of an ulinastatin modified LPDG solution. Ulinastatin further attenuated lung I/R injury, at least partly by reducing oxidative reactions,inhibiting the release of inflammatory factors and neutrophils immigration.
文摘OBJECTIVE: To test the validity of continuous low-flow perfusion with low-potassium dextran (LPD) to preserve rabbit lung. METHODS: Isolated rabbit lungs were preserved for eight hours either in Ringer's solution by simple storage (Group I) or in continuous low-flow perfusion with LPD (Group II). After preservation, lung functions were assessed to compare these two methods. RESULTS: The water gain in Group I was higher than that in Group II. During reperfusion, the functional test values for the immersed lungs were lower than those for the perfused lungs. The lipid peroxidation product (MDA) was significantly decreased in perfused lungs during reperfusion. CONCLUSIONS: Low-flow perfusion with LPD is better than immersion for the lung preservation.
文摘Methods Ten pairs of adult canines underwent left lung allotransplantation. Five donors were treated with ischemic preconditioning [their left hilus was clamped for 10 minutes and released for 15 minutes (Group IP)], and five donors were not treated with ischemic preconditioning (Group C). The donor lungs were flushed with 4℃ Euro Collin's solution (ECS) and stored in the same solution for two and a half hour, then transplanted to the recipient canines, who were observed for one to two hours after transplantation. The lung venous blood of the recipient and the donor lung tissue were collected just after thoracotomy and one hour after reperfusion of the transplanted lung in both groups. Results The number of polymorphonuclear (PMN) was significantly higher in Group IP than in Group C (P<0.05). However, the number of PMN in lung interstitium under microscope was less in Group IP than in Group C. The thromboxane (TXB 2), malondialdehyde (MDA) and mean pulmonary artery pressure (MPAP) contents were significantly lower in Group IP than in Group C (P<0.05). The superoxide dismutase (SOD) and the lung venous blood oxygen tension (PvO 2) contents were significantly higher in Group IP than in Group C (P<0.05). Histological findings showed less damages in Group IP than in Group C. Conclusions The protective effect of ischemic preconditioning together with ECS flush and storage is superior to using ECS alone. The possible mechanisms may be that ischemic preconditioning inhibits the accumulation and activation of PMN in lung tissue and reduces the production of oxygen free radicals.
