Parent R, Stanley P, Chartrand C
Eur Surg Res. 1987;19(4):193-9. doi: 10.1159/000128700.
Cardiac transplantation is followed by the interruption of afferent nerves to the heart. Knowing that some of the afferent nerves are responsible for the homeostasis of the blood volume, we undertook a serial and long-term study of the blood volume in 25 dogs with denervated hearts. The animals were autotransplanted in order to eliminate repercussions linked to rejection and to its treatment. To discern the effects of surgery and of extracorporeal circulation from those of denervation, a group of 11 control dogs was operated upon and subjected to a period of extracorporeal circulation. In both groups, serial and long-term studies of blood volume were carried out daily with 131I-labeled albumin. Analysis of the results demonstrated that in the hours following surgery, blood volume is significantly decreased by 11% in the control group and by 22% in group 2. By the 5th postoperative day, the blood volume had increased gradually to attain normal values in both groups. At the 2nd postoperative week, the total blood volume remained normal in the control group, whereas blood volume had increased by 5.7% in the autotransplanted dogs, this being due to a 38% increase of the plasmatic phase. This increment persisted from the 14th to the 42nd postoperative day and attained 7.4%. Our conclusion is that the variations in blood volume during the 1st postoperative week in the autotransplanted heart are inherent in surgery and in extracorporeal circulation. Afterwards, the hypervolemia shown in the transplanted dogs is secondary to cardiac denervation.
心脏移植后,心脏的传入神经会被切断。鉴于部分传入神经对血容量的稳态起作用,我们对25只心脏去神经支配的犬进行了血容量的系列长期研究。为消除与排斥反应及其治疗相关的影响,这些动物接受了自体移植。为区分手术和体外循环的影响与去神经支配的影响,对一组11只对照犬进行了手术并使其经历一段时间的体外循环。两组均每日用131I标记的白蛋白对血容量进行系列长期研究。结果分析表明,术后数小时,对照组血容量显著降低11%,第2组降低22%。术后第5天,两组血容量均逐渐增加至正常水平。术后第2周,对照组总血容量保持正常,而自体移植犬的血容量增加了5.7%,这是由于血浆部分增加了38%。这种增加从术后第14天持续到第42天,达到7.4%。我们的结论是,自体移植心脏术后第1周血容量的变化是手术和体外循环所固有的。此后,移植犬出现的血容量过多是心脏去神经支配的继发结果。