White J J, Tanser P H, Anthonisen N R, Wynands J E, Pare J A, Becklake M R, Munro D D, MacLean L D
Can Med Assoc J. 1966 Jun 4;94(23):1199-209.
Left lung homotransplantation was performed in a 31-year-old man in terminal irreversible respiratory failure due to advanced silicosis. Within 10 minutes of completion of transplantation, arterial pO(2) rose from 52 to 211 mm. Hg, pCO(2) dropped from 90 to 43 mm. Hg, and pH rose from 7.15 to 7.42. On assisted ventilation, arterial O(2) tension was maintained within normal limits for the first four days. Thereafter, arterio-alveolar difference for O(2) increased to 300 mm. and that for CO(2) to 25 mm. Xenon-133 ventilation perfusion ratios confirmed differences between the two lungs. Terminally, bronchopneumonia and hypoxemia were present. Surfactant content of the lung was within normal limits. Postmortem examination revealed bronchopneumonia, bronchial infarction, lymphatic engorgement and mild rejection. Future efforts should emphasize selection of non-infected donors, minimal reliance on steroids for immunosuppression, cardiopulmonary bypass during transplantation, and more definite criteria for rejection.
对一名因晚期矽肺病导致终末期不可逆呼吸衰竭的31岁男性进行了左肺同种移植。移植完成后10分钟内，动脉血氧分压从52毫米汞柱升至211毫米汞柱，二氧化碳分压从90毫米汞柱降至43毫米汞柱，pH值从7.15升至7.42。在辅助通气下，动脉血氧张力在前四天维持在正常范围内。此后，氧的动-肺泡差值增至300毫米汞柱，二氧化碳的动-肺泡差值增至25毫米汞柱。氙-133通气灌注比值证实了两肺之间的差异。终末期时，出现支气管肺炎和低氧血症。肺表面活性物质含量在正常范围内。尸检显示有支气管肺炎、支气管梗死、淋巴管充血和轻度排斥反应。未来的努力应着重于选择未感染的供体、尽量减少对类固醇免疫抑制的依赖、移植期间进行体外循环以及制定更明确的排斥反应标准。
