Sung S W, Won T
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, 28 Yongon, Chongno, 110-744, Seoul, South Korea.
Eur J Cardiothorac Surg. 2001 Jan;19(1):14-8. doi: 10.1016/s1010-7940(00)00624-2.
Donor airway ischemia is a significant problem after tracheal replacement with homograft or lung transplantation. Omentopexy is the usual countermeasure to prevent or overcome the ischemia of the airway but this is frequently not sufficient. This study was designed to investigate whether basic fibroblast growth factor (bFGF) can augment tracheal revascularization and its epithelial regeneration in rabbit tracheal autograft.
About half the length (44-45%) of the trachea of New Zealand white rabbit were autotransplanted in the original position immediately after harvest. In group I (n=15, control group), cervical tracheal autotransplantation was done only. In group II (n=15, omentopexy group), the cervical tracheal autograft was wrapped with subcutaneously advanced omentum. In group III (n=15, bFGF group), 1 microg of bFGF was applied evenly on the graft after the completion of anastomosis. Five animals in each group were examined on the 3rd, 7th and 14th postoperative days. Three rings of trachea were taken at the mid portion of the graft and the supra-carinal untouched normal trachea in each. The effect of revascularization was assessed by measuring the uptake of human serum albumin labeled with 99m technetium, which was injected into the left atrium just before sacrifice. The epithelial regeneration was assessed by means of light microscopic examination.
The proportion of perfusion of the graft to normal trachea was much higher in group III (P<0.05) on day 3 (25.4, 27.8 and 54.7% in groups I, II and III, respectively), but there was no difference on the 7th and 14th days. The epithelial regeneration was better in group III (P<0.05) than in the other groups on day 3, and was better in groups II and III than group I on day 7.
we concluded that bFGF enhances the revascularization and epithelial regeneration of the tracheal autograft, especially during their early phases.
在同种异体气管移植或肺移植后，供体气道缺血是一个重要问题。网膜固定术是预防或克服气道缺血的常用对策，但这往往并不充分。本研究旨在探讨碱性成纤维细胞生长因子（bFGF）是否能增强兔自体气管移植中的气管再血管化及其上皮再生。
新西兰白兔气管约一半长度（44 - 45%）在摘取后立即原位自体移植。I组（n = 15，对照组）仅进行颈段气管自体移植。II组（n = 15，网膜固定术组），颈段自体气管移植用皮下推进的网膜包裹。III组（n = 15，bFGF组），吻合完成后将1微克bFGF均匀涂抹于移植物上。每组5只动物在术后第3、7和14天进行检查。在移植物中部及每个标本中隆突上方未触及的正常气管处取三个气管环。通过测量注入左心房的99m锝标记人血清白蛋白的摄取量来评估再血管化效果，在处死前进行该操作。通过光学显微镜检查评估上皮再生情况。
术后第3天，III组移植物与正常气管的灌注比例显著高于I组（P < 0.05）（I组、II组和III组分别为25.4%、27.8%和54.7%），但在第7天和第14天无差异。术后第3天，III组上皮再生优于其他组（P < 0.05），第7天II组和III组上皮再生优于I组。
我们得出结论，bFGF可增强自体气管移植的再血管化和上皮再生，尤其是在早期阶段。
