Mills A N, Hooper T L, Hall S M, McGregor C G, Haworth S G
Department of Paediatric Cardiology, Institute of Child Health, London, UK.
J Heart Lung Transplant. 1992 Jan-Feb;11(1 Pt 1):58-67.
The left lung was transplanted in 12 adult beagles; the donor lung had been preserved by flush perfusion of the pulmonary artery with 60 ml/kg of Euro-Collins solution at 4 degrees C then stored in Euro-Collins solution at 4 degrees C for 6 hours. Biopsy specimens were taken from control and donor left lungs before and immediately after perfusion, after 6 hours storage, and after transplantation at 4 and 24 hours (total = 46). Tissue from seven animals was injected with the tracer ruthenium red. All tissue was examined by light and electron microscopy. After preservation capillary edema developed, but ruthenium red did not penetrate junction complexes, indicating structurally intact complexes. The proportion of ruthenium red-labeled plasmalemmal vesicles decreased (p less than 0.05). Endothelial cells and type I pneumonocytes because abnormally thin and detached from the basement membrane. The epithelial, but not the endothelial, sheet was disrupted. Four hours after transplantation, edema decreased, and endothelial and epithelial cells regained a more normal shape. The proportion of labeled plasmalemmal vesicles increased (p less than 0.05) by 24 hours, when the value was similar to normal. During preservation, edema formed when alveolar capillary white cell count was normal and decreased after reperfusion when the cells increased threefold (p less than 0.001), indicating that edema was not neutrophil dependent. Many small muscular arteries constricted intensely on cold perfusion. Four hours after transplantation, these abnormalities had improved.
The pulmonary vasculature showed no evidence that it had sustained additional structural injury after reperfusion. Reperfusion was associated with a gradual resolution of the structural abnormalities incurred during preservation.
将左肺移植到12只成年比格犬体内；供体肺用60ml/kg的欧洲柯林斯溶液在4℃下经肺动脉冲洗灌注后，再于4℃的欧洲柯林斯溶液中保存6小时。在灌注前、灌注后即刻、保存6小时后以及移植后4小时和24小时（共46个样本），从对照和供体左肺获取活检标本。对7只动物的组织注射示踪剂钌红。所有组织均通过光镜和电镜检查。保存后出现毛细血管水肿，但钌红未穿透连接复合体，表明复合体结构完整。钌红标记的质膜小泡比例降低（p<0.05）。内皮细胞和I型肺细胞变得异常变薄并与基底膜分离。上皮层而非内皮层遭到破坏。移植4小时后，水肿减轻，内皮细胞和上皮细胞恢复更正常的形态。到24小时时，标记的质膜小泡比例增加（p<0.05），此时该值与正常相似。在保存期间，当肺泡毛细血管白细胞计数正常时形成水肿，再灌注后细胞增加三倍时水肿减轻（p<0.001），表明水肿并非依赖中性粒细胞。许多小肌性动脉在冷灌注时强烈收缩。移植4小时后，这些异常情况有所改善。
肺血管系统未显示出再灌注后遭受额外结构损伤的证据。再灌注与保存期间发生的结构异常逐渐缓解相关。
