Kiser A C, Ciriaco P, Hoffmann S C, Egan T M
Division of Cardiothoracic Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
J Thorac Cardiovasc Surg. 2001 Jul;122(1):18-23. doi: 10.1067/mtc.2001.114634.
Lungs retrieved from cadavers after death and circulatory arrest may alleviate the critical shortage of lungs for transplant. We report a rat lung transplantation model that allows serial measurement of arterial blood gases after left single lung transplantation from non-heart beating donors.
Twelve Sprague-Dawley rats underwent left lung transplantation with a vascular cuff technique. Donor rats were anesthetized with intraperitoneal injection of pentobarbital, heparinized, intubated via tracheotomy, and then killed with pentobarbital. Lungs were retrieved immediately or after 2 hours of oxygen ventilation after death (tidal volume 1 mL/100 g, rate 40/min FIO2 = 1.0, positive end-expiratory pressure 5 cm H2O). Recipient rats were anesthetized, intubated, and ventilated. The carotid artery and jugular vein were cannulated for arterial blood gases and infusion of Ringer's lactate (4 mL/h). Anesthesia was maintained with halothane 0.2%, and recipient arterial blood gases were measured at 4 and 6 hours after lung transplantation after snaring the right pulmonary artery for 5 minutes. Animals were put to death 6 hours after lung transplantation, and portions of transplanted lungs were frozen in liquid nitrogen and assayed for wet/dry ratio, myeloperoxidase as a measure of neutrophil infiltration, and conjugated dienes as a measure of free radical-mediated lipid peroxidation.
Arterial PO2 and wet/dry ratio were not significantly different in recipients of non-heart beating donor lungs retrieved immediately after death or after 2 hours of oxygen ventilation. Significant neutrophil infiltration was observed in recipients of non-heart beating donor lungs retrieved 2 hours after death from oxygen-ventilated donors.
Strategies to ameliorate reperfusion injury may allow for successful lung transplantation from non-heart beating donors.
从死亡并发生循环停止后的尸体获取的肺脏或许能缓解移植肺脏严重短缺的问题。我们报告一种大鼠肺移植模型,该模型能在从非心脏跳动供体进行左单肺移植后对动脉血气进行系列测量。
12只Sprague-Dawley大鼠采用血管套技术接受左肺移植。供体大鼠经腹腔注射戊巴比妥麻醉、肝素化、经气管切开插管,然后用戊巴比妥处死。肺脏在死亡后立即获取,或在氧气通气2小时后获取(潮气量1 mL/100 g,频率40次/分钟,FIO2 = 1.0,呼气末正压5 cm H2O)。受体大鼠麻醉、插管并通气。颈动脉和颈静脉插管用于测量动脉血气和输注乳酸林格液(4 mL/小时)。用0.2%的氟烷维持麻醉,在阻断右肺动脉5分钟后于肺移植后4小时和6小时测量受体动脉血气。肺移植后6小时处死动物,将部分移植肺脏在液氮中冷冻,并检测湿/干比、作为中性粒细胞浸润指标的髓过氧化物酶以及作为自由基介导的脂质过氧化指标的共轭二烯。
在死亡后立即获取或氧气通气2小时后获取的非心脏跳动供体肺脏的受体中,动脉PO2和湿/干比无显著差异。在氧气通气的供体死亡2小时后获取的非心脏跳动供体肺脏的受体中观察到显著的中性粒细胞浸润。
改善再灌注损伤的策略可能使从非心脏跳动供体成功进行肺移植成为可能。