Naka Y, Shirakura R, Matsuda H, Nakata S, Fukushima N, Nakano S, Kawashima Y
First Department of Surgery, Osaka University Medical School, Japan.
J Heart Lung Transplant. 1991 Mar-Apr;10(2):296-302; discussion 303.
Twenty four-hour heart-lung preservation with Belzer-UW solution was studied in the canine heterotopic heart-lung transplant model. Four pairs of mongrel dogs were used. The donor heart was arrested with cardioplegic solution. The heart and the lung were flushed with UW solution, then excised en bloc and immersed in 4 degrees C UW solution for 24 hours. The graft was transplanted heterotopically into the left pneumonectomized recipient. The transplant procedure consisted of end-to-end anastomosis of two left main bronchi, end-to-side anastomosis of the descending aortas, and end-to-end anastomosis of the donor's superior vena cava to the recipient's left pulmonary artery. The recipient's right pulmonary artery was ligated after an observation period, and cardiopulmonary functions were measured during room air ventilation. In all four transplanted dogs the grafts were able to sustain the recipient's circulation. The prepreservation and posttransplant cardiac output was 71.2 +/- 21.6 ml/min/kg and 96.4 +/- 44.4 ml/min/kg; the arterial PO2 was 80.8 +/- 12.9 mm Hg and 74.1 +/- 2.7 mm Hg; and the arterial PCO2 was 25.6 +/- 5.5 mm Hg and 35.9 +/- 13.3 mm Hg, respectively. There were no significant differences between the prepreservation and posttransplant values. Posttransplant myocardial water content was within the normal range. Pulmonary vascular resistance increased significantly, to 13.8 +/- 3.7 from 8.8 +/- 5.2. Wood units, and the wet/dry ratio of the lung increased significantly, to 8.3 +/- 1.6 from 4.4 +/- 0.6. In conclusion, heart-lung grafts preserved in UW solution for 24 hours were able to sustain the recipient's circulation. Significant pulmonary edema, however, could not be prevented.
在犬异位心肺移植模型中研究了用Belzer-UW溶液进行24小时心肺保存。使用了四对杂种犬。供体心脏用心脏停搏液停搏。心脏和肺用UW溶液冲洗，然后整块切除并浸入4℃的UW溶液中24小时。移植物异位移植到左肺切除的受体中。移植手术包括两个左主支气管的端端吻合、降主动脉的端侧吻合以及供体上腔静脉与受体左肺动脉的端端吻合。观察一段时间后结扎受体右肺动脉，并在室内空气通气期间测量心肺功能。在所有四只移植犬中，移植物都能够维持受体的循环。保存前和移植后的心输出量分别为71.2±21.6 ml/min/kg和96.4±44.4 ml/min/kg；动脉血氧分压分别为80.8±12.9 mmHg和74.1±2.7 mmHg；动脉血二氧化碳分压分别为25.6±5.5 mmHg和35.9±13.3 mmHg。保存前和移植后的值之间没有显著差异。移植后心肌含水量在正常范围内。肺血管阻力显著增加，从8.8±5.2 Wood单位增加到13.8±3.7 Wood单位，肺的湿/干比也显著增加，从4.4±0.6增加到8.3±1.6。总之，用UW溶液保存24小时的心肺移植物能够维持受体的循环。然而，严重的肺水肿无法预防。
