Ueda K, Date H, Fujita T, Oto T, Nagahiro I, Aoe M, Andou A, Shimizu N
Second Department of Surgery, Okayama University School of Medicine, 2-5-1 Shikatacho, Okayama 700-8558, Japan.
Jpn J Thorac Cardiovasc Surg. 2000 Nov;48(11):693-9. doi: 10.1007/BF03218234.
In living-donor lobar lung transplantation, early severe graft dysfunction can occur if the size or amount of transplanted lung tissue is insufficient. The purpose of this study was to evaluate the effects of inhaled nitric oxide on early pulmonary function in a canine bilateral living-donor lobar lung transplant model.
Sixteen pairs of mongrel dogs with a donor/recipient weight ratio less than 1.2 were used. The donor lung bloc was extirpated after heparinization. Right middle, lower and cardiac lobes were implanted as a right lung of the recipient and left lower lobe was implanted as a left lung without cardiopulmonary bypass. In Group 1 (n = 9), nitric oxide gas was administered continuously at a concentration of 40 parts per million prior to reperfusion of the right lung throughout the 6-hour assessment period after transplantation. In Group 2 (n = 7), nitrogen gas was administered in the same manner as nitric oxide, for control.
At the end of assessment, the survival rate was 89% (8/9) in Group 1 and 57% (4/7) in Group 2. The arterial oxygen tension in Group 1 was significantly higher than that in Group 2. The pulmonary arterial pressure and pulmonary vascular resistance index were significantly lower in Group 1 than in Group 2. The aortic pressure and cardiac index did not differ significantly between the two groups. The wet-to-dry weight ratio and myeloperoxidase activity were significantly lower in Group 1 than in Group 2.
These data suggested that inhaled nitric oxide improved early pulmonary function in living-donor lobar lung transplantation by vasodilatating the pulmonary vasculature and inhibiting neutrophil activation.
在活体供肺叶移植中，如果移植肺组织的大小或数量不足，可能会发生早期严重移植肺功能障碍。本研究的目的是评估吸入一氧化氮对犬双侧活体供肺叶移植模型早期肺功能的影响。
使用16对供体/受体体重比小于1.2的杂种犬。供肺在肝素化后切除。右肺中叶、下叶和心叶作为受体的右肺植入，左肺下叶作为左肺植入，无需体外循环。在第1组（n = 9）中，在移植后6小时的评估期内，在右肺再灌注前以百万分之40的浓度持续给予一氧化氮气体。在第2组（n = 7）中，以与一氧化氮相同的方式给予氮气作为对照。
评估结束时，第1组的存活率为89%（8/9），第2组为57%（4/7）。第1组的动脉血氧张力显著高于第2组。第1组的肺动脉压和肺血管阻力指数显著低于第2组。两组之间的主动脉压和心脏指数无显著差异。第1组的湿重与干重比和髓过氧化物酶活性显著低于第
