Yamashita C, Tsuji F, Oobo H, Tobe S, Yamamoto H, Nakamura H, Okada M, Nakamura K
Department of Surgery, Kobe University School of Medicine, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1991 Nov;39(11):2002-5.
Transient impairment of the transplanted lung in early postoperative period is one of difficult problems in lung transplantation. It is likely that reperfusion injury of the warm ischemic lung is contributory. The purpose of this study is to evaluate the effects of superoxide dismutase (SOD) on reperfusion injury of warm ischemic lung. Thirty mongrel dogs were divided into four groups. In group I (n = 6), the left lung with complete hilar stripping was placed in warm ischemic state under deflation for 1 hour. In group II (n = 9), the left lung with complete hilar stripping was kept in warm ischemic condition under inflation. Group III (n = 6) animals with same manipulation as group I received superoxide dismutase (SOD 20 mg/kg) before reperfusion. Group IV (n = 9) animals underwent same manipulation as group II and received SOD (20 mg/kg) before reperfusion. Before warm ischemia, immediately after reperfusion, and 1 and 2 hours, blood gases, left pulmonary vascular resistance were measured under the occlusion of right pulmonary artery. Extra vascular lung water content (EVLW) was measured at autopsy and lung was processed for histology. In group II, III and IV, blood gases and EVLW showed significantly better values than group I. In group I and III, left pulmonary vascular resistance increased prominently after reperfusion, however did not change in group II and IV. From these results, we concluded that inflated lung reduced the extent of pulmonary edema after reperfusion and SOD was effective in preventing warm ischemic damage even in deflated lung.
术后早期移植肺的短暂功能损害是肺移植中的难题之一。热缺血肺的再灌注损伤可能是其原因之一。本研究的目的是评估超氧化物歧化酶（SOD）对热缺血肺再灌注损伤的影响。30只杂种犬分为四组。第一组（n = 6），将完全剥离肺门的左肺在萎陷状态下置于热缺血状态1小时。第二组（n = 9），将完全剥离肺门的左肺在充气状态下保持热缺血状态。第三组（n = 6）动物进行与第一组相同的操作，并在再灌注前给予超氧化物歧化酶（SOD 20 mg/kg）。第四组（n = 9）动物进行与第二组相同的操作，并在再灌注前给予SOD（20 mg/kg）。在热缺血前、再灌注后即刻以及1小时和2小时，在右肺动脉阻断下测量血气、左肺血管阻力。在尸检时测量血管外肺水含量（EVLW），并对肺进行组织学处理。在第二组、第三组和第四组中，血气和EVLW的值明显优于第一组。在第一组和第三组中，再灌注后左肺血管阻力显著增加，而在第二组和第四组中未发生变化。从这些结果中，我们得出结论，充气肺可减轻再灌注后肺水肿的程度，并且即使在萎陷肺中，SOD在预防热缺血损伤方面也是有效的。
