Gennai Stéphane, Pison Christophe, Briot Raphaël
CHU de Grenoble, pôle urgences et médecine aiguë, CS 10217, 38043 Grenoble cedex 09, France; Laboratoire TIMC-IMAG, UMR 5525, domaine de la Merci, 38706 La Tronche cedex, France.
Université Joseph-Fourier, laboratoire de bioénergétique fondamentale et appliquée, Inserm U1055, BP 53, 38041 Grenoble cedex 09, France.
Presse Med. 2014 Sep;43(9):921-30. doi: 10.1016/j.lpm.2014.01.018. Epub 2014 Jun 13.
Lung ischemia-reperfusion is characterized by diffuse alveolar damage arising from the first hours after transplantation. The first etiology of the primary graft dysfunction in lung is ischemia-reperfusion. It is burdened by an important morbi-mortality. Lung ischemia-reperfusion increases the oxidative stress, inactivates the sodium pump, increases the intracellular calcium, leads to cellular death and the liberation of pro-inflammatory mediators. Researches relative to the reduction of the lung ischemia-reperfusion injuries are numerous but few of them found a place in common clinical practice, because of an insufficient level of proofs. Ex vivolung evaluation is a suitable technique in order to evaluate therapeutics supposed to limit lung ischemia-reperfusion injuries.
肺缺血再灌注的特征是移植后最初数小时出现弥漫性肺泡损伤。肺原发性移植功能障碍的首要病因是缺血再灌注。它具有较高的病残率和死亡率。肺缺血再灌注会增加氧化应激,使钠泵失活,增加细胞内钙含量,导致细胞死亡并释放促炎介质。关于减轻肺缺血再灌注损伤的研究很多,但由于证据水平不足,其中很少有在临床实践中得到应用。体外肺评估是一种合适的技术,用于评估旨在限制肺缺血再灌注损伤的治疗方法。