Ueda K, Hatanaka M, Kyo S, Takamoto S, Yokote Y, Arima T, Yamashina M, Omoto R
Department of Surgery, Saitama Medical School, Japan.
J Heart Transplant. 1987 May-Jun;6(3):155-61.
Pulmonary edema and impaired gas exchange function are worrisome early complications of heart-lung transplantation. The present study was designed to determine the effect of a new prostacyclin analog, OP-41483, on these complications with the use of a heart-lung autoperfusion model. Twenty-four mongrel puppies (4 to 6 kg) were evenly divided into four groups according to the oxygen content of inspired air (group 1, 95%; group 2, 60%) and the use of an intravenous drip of OP-41483 (0.1 microgram/kg/min) (group 3, 95% + OP; group 4, 60% + OP). During the course of these experiments, systolic pressure and cardiac output were maintained constant at 100 mm Hg and 40 ml/kg/min, respectively. Pulmonary arterial pressure was almost constant in each group throughout the experiment. Arterial oxygen tension (Pao2) was significantly decreased in groups 1 (410 +/- 49 to 237 +/- 38 mm Hg, p less than 0.01) and 2 (368 +/- 44 to 243 +/- 26 mm Hg, p less than 0.01) over the 5-hour autoperfusion period but was maintained at a high level in groups 3 (488 +/- 70 to 447 +/- 39 mm Hg) and 4 (431 +/- 33 to 430 +/- 35 mm Hg). Pathologic findings (perivascular edema and capillary dilatation) were significant in group 1 but less marked in group 2. However, no abnormal pathologic changes were observed in groups 3 or 4. These data demonstrated that OP-41483 was effective in preventing functional and pathologic pulmonary disturbances at a dosage (0.1 microgram/kg/min) that is reported to induce no undesirable hemodynamic effect.
肺水肿和气体交换功能受损是心肺移植早期令人担忧的并发症。本研究旨在使用心肺自体灌注模型来确定一种新型前列环素类似物OP - 41483对这些并发症的影响。将24只杂种幼犬（4至6千克）根据吸入空气的氧含量（第1组，95%；第2组，60%）和是否静脉滴注OP - 41483（0.1微克/千克/分钟）（第3组，95% + OP；第4组，60% + OP）平均分为四组。在这些实验过程中，收缩压和心输出量分别维持在100毫米汞柱和40毫升/千克/分钟恒定。整个实验过程中每组的肺动脉压几乎恒定。在5小时的自体灌注期内，第1组（从410±49降至237±38毫米汞柱，p < 0.01）和第2组（从368±44降至243±26毫米汞柱，p < 0.01）的动脉血氧分压（Pao2）显著降低，但第3组（从488±70降至447±39毫米汞柱）和第4组（从431±33降至430±35毫米汞柱）维持在较高水平。病理结果（血管周围水肿和毛细血管扩张）在第1组显著，但在第2组不太明显。然而，在第3组或第4组未观察到异常病理变化。这些数据表明，OP - 41483在剂量为0.1微克/千克/分钟时可有效预防功能性和病理性肺部紊乱，据报道该剂量不会引起不良血流动力学效应。
