Avlonitis Vassilios S, Fisher Andrew J, Kirby John A, Dark John H
School of Surgical and Reproductive Sciences (Surgery), Medical School, University of Newcastle upon Tyne, Framlington Place, Newcastle upon Tyne, NE2 4HH, United Kingdom.
Transplantation. 2003 Jun 27;75(12):1928-33. doi: 10.1097/01.TP.0000066351.87480.9E.
The paucity of suitable lung donors and the high early mortality as the result of primary graft failure remain major challenges in pulmonary transplantation. There is evidence that the lung is injured in the donor by the process of brain death and often is made unusable or fails posttransplantation after amplification of the injury by the process of ischemia-reperfusion. An understanding of the mechanism of donor lung injury could lead to the development of new treatment strategies for the donor to reduce lung injury, increase the number of donors with acceptable lungs, and improve the results of transplantation. The pathophysiology of brain death is complex and involves sympathetic, hemodynamic, and inflammatory mechanisms that can injure the lung. The literature is reviewed, and these mechanisms are discussed together with their possible interrelations.
合适肺供体的稀缺以及原发性移植肺功能衰竭导致的早期高死亡率仍是肺移植的主要挑战。有证据表明，在供体中，肺会因脑死亡过程而受损，并且在缺血再灌注过程使损伤扩大后，常常变得无法使用或在移植后发生功能衰竭。了解供体肺损伤的机制可能会促使开发新的供体治疗策略，以减少肺损伤、增加具有可用肺的供体数量并改善移植结果。脑死亡的病理生理学很复杂，涉及可损伤肺的交感神经、血流动力学和炎症机制。本文对相关文献进行了综述，并讨论了这些机制及其可能的相互关系。
