Katayama Y, Hatanaka K, Hayashi T, Onoda K, Namikawa S, Yuasa H, Yada I, Maruyama K, Kitabatake M, Kusagawa M
Department of Thoracic and Cardiovascular Surgery, Mie University Medical School, Tsu, Japan.
J Heart Lung Transplant. 1995 May-Jun;14(3):486-92.
The edema of grafted lungs during the early postoperative period is one of the serious complications of single lung transplantation for primary pulmonary hypertension.
The effectiveness of inhaled nitric oxide in single lung transplantation for primary pulmonary hypertension during the early postoperative period was evaluated with the use of rats with monocrotaline-induced pulmonary hypertension. In the inhaled nitric oxide group, rats were given 60 parts par million of nitric oxide for 24 hours just after left lung transplantation; in the no inhaled nitric oxide group, rats were kept without nitric oxide inhalation; in the control group, normal rats received left isografts.
Three hours after transplantation, the mean pulmonary artery pressure of the no inhaled nitric oxide group (28.0 +/- 4.6) was significantly higher than that of the control group (23.3 +/- 0.9, p < 0.05) and the inhaled nitric oxide group (22.7 +/- 1.7, p < 0.05). On the first postoperative day, the mean left-to-right pulmonary blood flow ratio in the inhaled nitric oxide group was 0.34 +/- 0.03; it showed no significant difference to those of the other two groups, whereas that of the no inhaled nitric oxide group (0.42 +/- 0.14) was significantly elevated compared with that of the control group (0.14 +/- 0.03, p < 0.05). Histopathologically, the edema of the grafted lungs 24 hours after operation in the inhaled nitric oxide group was less severe than that in the no inhaled nitric oxide group.
The postoperative use of inhaled nitric oxide is effective to reduce the pulmonary edema of the grafts in single lung transplantation for pulmonary hypertension by reducing acute pulmonary blood flow shift toward grafts after transplantation.
术后早期移植肺水肿是原发性肺动脉高压单肺移植的严重并发症之一。
使用野百合碱诱导肺动脉高压的大鼠评估吸入一氧化氮在原发性肺动脉高压单肺移植术后早期的有效性。在吸入一氧化氮组，大鼠左肺移植后立即给予60ppm一氧化氮，持续24小时；在未吸入一氧化氮组，大鼠不吸入一氧化氮；在对照组，正常大鼠接受左肺同基因移植。
移植后3小时，未吸入一氧化氮组的平均肺动脉压（28.0±4.6）显著高于对照组（23.3±0.9，p<0.05）和吸入一氧化氮组（22.7±1.7，p<0.05）。术后第1天，吸入一氧化氮组的平均左右肺血流比为0.34±0.03；与其他两组相比无显著差异，而未吸入一氧化氮组的平均左右肺血流比（0.42±0.14）与对照组（0.14±0.03，p<0.05）相比显著升高。组织病理学检查显示，吸入一氧化氮组术后24小时移植肺的水肿程度比未吸入一氧化氮组轻。
术后使用吸入一氧化氮可通过减少移植后急性肺血流向移植肺的转移，有效减轻肺动脉高压单肺移植中移植肺的水肿。
