Sueda T, Matsuura Y, Matsushima T, Mukai S, Kajihara H
First Department of Surgery, Hiroshima University School of Medicine, Japan.
Hiroshima J Med Sci. 1990 Mar;39(1):15-8.
A model of heterotopic cardiac transplantation for diagnosis of rejection is described. Heterotopic cardiac transplantations were performed in the thorax using the left innominate artery as an arterial supply with venous return into the superior vena cava. Six pairs of mongrel dogs underwent cardiac transplantation using this technique. Two dogs died postoperatively on the 2nd and 3rd day due to respiratory failure. Another four donor hearts arrested their beats in 6 to 8 postoperative days (mean 6.3 days) resulting from acute cardiac rejection. Serial echocardiographic recordings were found to be a reliable measure of acute cardiac rejection, since the left ventricular wall thickness of the donor heart increased until the donor heart stopped by rejection. Endomyocardial biopsy was easy to perform by passage of flexible cardiac biotome into the right ventricle of the donor and the recipient heart through the right internal jugular vein. Pathological findings revealed that early changes of the donor heart were interstitial edema caused by myocardial ischemia. This was followed by lymphocyte infiltration around peripheral coronary arteries and acute rejection resulting in myocyte necrosis.
描述了一种用于诊断排斥反应的异位心脏移植模型。在胸腔内进行异位心脏移植，使用左无名动脉作为动脉供血，静脉回流至上腔静脉。六对杂种犬采用该技术进行了心脏移植。两只犬在术后第2天和第3天因呼吸衰竭死亡。另外四只供体心脏在术后6至8天（平均6.3天）因急性心脏排斥反应而停跳。连续超声心动图记录被发现是急性心脏排斥反应的可靠测量方法，因为供体心脏的左心室壁厚度在因排斥反应导致供体心脏停跳之前会增加。通过柔性心脏活检钳经右颈内静脉进入供体和受体心脏的右心室，心内膜活检很容易进行。病理结果显示，供体心脏的早期变化是由心肌缺血引起的间质水肿。随后是外周冠状动脉周围的淋巴细胞浸润和导致心肌细胞坏死的急性排斥反应。
