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一种用于肺保存的新溶液(加州大学洛杉矶分校配方)。

A new solution (UCLA formula) for lung preservation.

作者信息

Hachida M, Morton D L

机构信息

Division of Surgical Oncology, Armand Hammer Laboratories, UCLA School of Medicine 90024.

出版信息

J Thorac Cardiovasc Surg. 1989 Apr;97(4):513-20.

PMID:2648079
Abstract

In previous studies, we revealed the beneficial effects of verapamil and glucose-insulin-potassium solution in lung preservation. In this study, we composed a new solution (UCLA formula) containing both of these factors and compared it with Collins-Sachs solution in a canine autotransplantation model. A total of 15 dogs were used. The animals were assigned randomly to the two study groups. The left lungs of seven dogs were perfused with the UCLA formula and the left lungs of eight dogs with Collins-Sachs. Both solutions were at 4 degrees C. After 6 hours of preservation, the left lungs in both groups were autotransplanted. In the UCLA formula group, seven of seven dogs (100%) survived for the entire period of 2 weeks after the operation. In contrast, two of eight dogs in the Collins-Sachs group (25%) survived for longer than 24 hours. Pulmonary artery resistance (dyne.sec.cm-5) after transplantation was 499.8 +/- 144.8 in the UCLA group and 780.9 +/- 174.5 in the Collins-Sachs group (p less than 0.01). Pulmonary artery resistance was also ascertained with the right pulmonary artery occlusion test and showed 539.5 +/- 95.4 in the UCLA group and 1469.3 +/- 573.6 in the Collins-Sachs group (p less than 0.01). Oxygen tension (mm Hg) after lung transplantation was 74.1 +/- 10.6 in the UCLA group and 35.9 +/- 3.5 in the Collins-Sachs group (p less than 0.01). Postoperative oxygen tension with the right pulmonary artery occlusion test was measured daily for 7 days. Two survivors in the Collins-Sachs group showed significant deterioration of oxygen tension from the third postoperative day. Also, the relationship between the airway pressure and tidal volume showed a significant reduction in the Collins-Sachs group (p less than 0.01). In conclusion, the transplanted lung in which UCLA solution was used demonstrated improved lung function after 6 hours of preservation in comparison with function in lungs preserved with Collins-Sachs solution.

摘要

在先前的研究中,我们揭示了维拉帕米和葡萄糖 - 胰岛素 - 钾溶液在肺保存中的有益作用。在本研究中,我们配制了一种包含这两种因素的新溶液(加州大学洛杉矶分校配方),并在犬自体移植模型中将其与柯林斯 - 萨克斯溶液进行比较。总共使用了15只狗。将动物随机分配到两个研究组。7只狗的左肺用加州大学洛杉矶分校配方灌注,8只狗的左肺用柯林斯 - 萨克斯溶液灌注。两种溶液均在4摄氏度。保存6小时后,两组的左肺都进行了自体移植。在加州大学洛杉矶分校配方组中,7只狗中的7只(100%)在术后2周的整个期间存活。相比之下,柯林斯 - 萨克斯组的8只狗中有2只(25%)存活超过24小时。移植后肺动脉阻力(达因·秒·厘米⁻⁵)在加州大学洛杉矶分校组为499.8±144.8,在柯林斯 - 萨克斯组为780.9±174.5(p<0.01)。通过右肺动脉闭塞试验也测定了肺动脉阻力,在加州大学洛杉矶分校组为539.5±95.4,在柯林斯 - 萨克斯组为1469.3±573.6(p<0.01)。肺移植后的氧分压(毫米汞柱)在加州大学洛杉矶分校组为74.1±10.6,在柯林斯 - 萨克斯组为35.9±3.5(p<0.01)。术后7天每天通过右肺动脉闭塞试验测量氧分压。柯林斯 - 萨克斯组的两名幸存者从术后第三天起氧分压显著恶化。此外,气道压力与潮气量之间的关系在柯林斯 - 萨克斯组中显示出显著降低(p<0.01)。总之,与用柯林斯 - 萨克斯溶液保存的肺相比,使用加州大学洛杉矶分校溶液保存6小时后的移植肺显示出肺功能改善。

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