Okada Yoshinori, Kondo Takashi
Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Aobaku, Sendai, Japan.
Gen Thorac Cardiovasc Surg. 2009 Dec;57(12):635-9. doi: 10.1007/s11748-009-0492-3.
Despite the increasing success of lung transplantation as the mainstay therapeutic modality for end-stage lung disease, the 1-year survival rate after lung transplantation remains 80% and primary graft dysfunction (PGD) accounts for 30% of mortality. Ischemia-reperfusion injury has been identified as one of the main causes of PGD, and thus significant efforts have been made to optimize the methods for lung preservation in an attempt to minimize lung injury during the period of ischemia. The composition of the lung preservation solution used in the pulmonary artery flush has been considered to be the key to successful lung preservation, and many lung transplant programs have been shifting the use of the preservation solution from the intracellular fluid type to the extracellular fluid type because of preferable posttransplant lung function with the latter. This review summarizes the experimental and clinical studies on lung preservation, particularly focusing attention on the preservation solution being employed for clinical lung transplantation.
尽管肺移植作为终末期肺病的主要治疗方式越来越成功,但肺移植后的1年生存率仍为80%,原发性移植肺功能障碍(PGD)占死亡率的30%。缺血再灌注损伤已被确定为PGD的主要原因之一,因此人们已做出巨大努力来优化肺保存方法,以尽量减少缺血期间的肺损伤。肺动脉冲洗中使用的肺保存液的成分被认为是成功进行肺保存的关键,由于使用细胞外液型保存液移植后的肺功能更佳,许多肺移植项目已将保存液的使用从细胞内液型转向细胞外液型。本综述总结了有关肺保存的实验和临床研究,尤其关注临床肺移植中使用的保存液。