Starobin D, Shitrit D, Steinmetz A, Fink G, Hardoff R, Kramer M R
Pulmonary Institute, Rabin Medical Center, Beilinson Campus, Petach-Tikva and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Thorac Cardiovasc Surg. 2007 Feb;55(1):48-52. doi: 10.1055/s-2006-924709.
Following successful lung transplantation, most of the lung perfusion, as well as ventilation, is shifted towards the transplanted lung. We investigated the changes in perfusion during exercise in lung transplant recipients.
Twelve patients were included in the study. Six patients had emphysema and 6 patients had idiopathic pulmonary fibrosis (IPF). Patients underwent two upright lung perfusion scans: the first at rest and the second during a maximal cardiopulmonary exercise test. Lung perfusion was assessed in each lung and regionally.
At rest, patients with emphysema had 83.3 +/- 8 % of total perfusion to the transplanted side and 16.7 +/- 8 % to the native lung, while in the IPF patients, it was 68.7 +/- 12 and 32.7 +/- 10 %, respectively ( P = 0.028). At peak exercise, perfusion shifted from the transplanted lung to the native lung ( P = 0.0095) both in emphysema and IPF patients.
Following successful lung transplantation, most of the perfusion is directed towards the transplanted lung. During exercise, there was a small but significant shift towards the native lung. These findings highlighted the important role of the native lung during maximal exercise.
肺移植成功后，大部分肺灌注以及通气都转向移植肺。我们研究了肺移植受者运动期间灌注的变化。
12例患者纳入本研究。6例患者患有肺气肿，6例患者患有特发性肺纤维化（IPF）。患者接受了两次直立位肺灌注扫描：第一次在静息状态下，第二次在最大心肺运动试验期间。对每个肺及各区域的肺灌注进行评估。
静息时，肺气肿患者移植侧肺的灌注占总灌注的83.3±8%，自身肺为16.7±8%；而IPF患者中，移植侧肺灌注占总灌注的68.7±12%，自身肺为32.7±10%（P = 0.028）。在运动峰值时，肺气肿和IPF患者的灌注均从移植肺转向自身肺（P = 0.0095）。
肺移植成功后，大部分灌注流向移植肺。运动期间，出现了向自身肺的少量但显著的灌注转移。这些发现凸显了自身肺在最大运动期间的重要作用。
