Dawkins K D, Haverich A, Derby G C, Scott W C, Reitz B A, Stinson E B, Jamieson S W, Shumway N E
J Thorac Cardiovasc Surg. 1985 Jan;89(1):55-62.
To assess the long-term hemodynamic consequences of combined heart and lung transplantation, we investigated six rhesus monkeys 2.6 to 4.6 years (mean 4.0) after operation. Total follow-up was 24.0 primate-years. Autotransplantation had been carried out in four animals and allotransplantation in two, and the hemodynamic results were compared with those in three normal monkeys of similar size. Each animal underwent simultaneous right and left heart catheterization and pulmonary arteriography. Hemodynamic measurements were made at three levels of inspired oxygen. Arterial oxygen tension was within normal limits in all animals, and pulmonary artery pressure and pulmonary vascular resistance index did not change significantly with changes in the levels of inspired oxygen. Indices of left ventricular systolic function were normal in all animals. Values for pulmonary artery pressure and pulmonary vascular resistance index were similar in the autograft and normal groups: in the allograft group, the average pressure was 30/17 mm Hg (mean 24) and the index was 5.6 units . m2--both levels significantly higher than normal (pressure was 16/10 mm Hg, mean 13, [p less than 0.001] and index was 2.5 units . m2 [p less than 0.02]). Pulmonary arteriography in the allograft group with the highest pulmonary vascular resistance index (6.1 units . m2) was compatible with pulmonary vascular disease. Pulmonary arteriograms in the remaining eight monkeys were normal. Prolonged survival following combined heart and lung transplantation is possible in primates. Autotransplantation (and probable persisting denervation of the cardiopulmonary axis) does not necessarily result in abnormal long-term hemodynamics. The elevation in pulmonary artery pressure and pulmonary vascular resistance index in the allograft group may be related to previous episodes of pulmonary rejection, infection, or drug reaction.
为评估心肺联合移植的长期血流动力学后果，我们对6只恒河猴在术后2.6至4.6年（平均4.0年）进行了研究。总随访时间为24.0灵长类动物年。4只动物进行了自体移植，2只进行了同种异体移植，并将血流动力学结果与3只大小相似的正常猴子进行了比较。每只动物均同时进行了左右心导管检查和肺动脉造影。在三种吸氧水平下进行了血流动力学测量。所有动物的动脉血氧张力均在正常范围内，肺动脉压和肺血管阻力指数并未随吸氧水平的变化而显著改变。所有动物的左心室收缩功能指标均正常。自体移植组和正常组的肺动脉压和肺血管阻力指数值相似：在同种异体移植组中，平均压力为30/17 mmHg（平均24），指数为5.6单位·m²，两者均显著高于正常水平（正常压力为16/10 mmHg，平均13，[p<0.001]，指数为2.5单位·m² [p<0.02]）。肺血管阻力指数最高（6.1单位·m²）的同种异体移植组的肺动脉造影符合肺血管疾病表现。其余8只猴子的肺动脉造影正常。灵长类动物心肺联合移植后有可能长期存活。自体移植（以及可能持续存在的心肺轴去神经支配）不一定会导致长期血流动力学异常。同种异体移植组中肺动脉压和肺血管阻力指数的升高可能与既往的肺排斥反应、感染或药物反应有关。
