Erasmus M E, Petersen A H, Oetomo S B, Prop J
Department of Cardiopulmonary Surgery, University Hospital Groningen, The Netherlands.
J Heart Lung Transplant. 1994 Sep-Oct;13(5):791-802.
In this study we investigated the surfactant function in rat lung transplants at the peak of the reimplantation response in experimental groups with increasing warm ischemic times of the lung transplant. The left and right lungs in five groups of rats were assessed 24 hours after left lung transplantation: rats receiving transplants with lung graft ischemic times of 60 (n = 4), 90 (n = 5), and 120 (n = 5) minutes, donor rats with 120 minutes lung ischemia (n = 5) and normal (nonoperated) rats (n = 6). The reimplantation response was assessed by the ventilation score on chest roentgenograms, measurement of the static lung compliance, and the (serum) protein concentration in the bronchoalveolar lavage fluid. Surfactant in the bronchoalveolar lavage fluid was assessed by measuring the amount and the composition of surfactant phospholipids and the in vitro surfactant function in a pulsating bubble surfactometer. We found that longer ischemic times caused a more severe reimplantation response in the left lung grafts. Although the ventilation scores were equally low in the 60-, 90-, and 120-minute ischemia groups, the lung compliances decreased and the (serum) protein concentrations increased stepwise in correlation with longer ischemic times. The amount of surfactant phospholipids during the reimplantation response was not changed, but the percentage phosphatidyl choline decreased progressively in parallel with the severity of the reimplantation response. Finally, the in vitro function of surfactant from the lung transplants decreased in parallel with the prolongation of the ischemic time, whereas the function of surfactant from donor lungs with 120 minutes of ischemia and from native right lungs was not changed. We conclude that the surfactant function is impaired during the reimplantation response as a result of a high concentration of inhibiting serum proteins and a low percentage of phosphatidyl choline.
在本研究中，我们在肺移植热缺血时间不断增加的实验组中，于再灌注反应高峰期，对大鼠肺移植中的表面活性剂功能进行了研究。在左肺移植24小时后，对五组大鼠的左右肺进行评估：接受移植的大鼠，其肺移植缺血时间分别为60分钟（n = 4）、90分钟（n = 5）和120分钟（n = 5），供体大鼠肺缺血120分钟（n = 5）以及正常（未手术）大鼠（n = 6）。通过胸部X线片上的通气评分、静态肺顺应性测量以及支气管肺泡灌洗液中的（血清）蛋白浓度来评估再灌注反应。通过测量支气管肺泡灌洗液中表面活性剂磷脂的含量和组成以及在脉动气泡表面活性测定仪中测定体外表面活性剂功能，来评估支气管肺泡灌洗液中的表面活性剂。我们发现，较长的缺血时间会导致左肺移植的再灌注反应更严重。尽管60分钟、90分钟和120分钟缺血组的通气评分同样较低，但肺顺应性降低，且（血清）蛋白浓度与缺血时间延长呈逐步增加的相关性。再灌注反应期间表面活性剂磷脂的含量未发生变化，但磷脂酰胆碱的百分比与再灌注反应的严重程度平行下降。最后，肺移植表面活性剂的体外功能随缺血时间延长而降低，而缺血120分钟的供体肺和右肺的表面活性剂功能未发生变化。我们得出结论，由于抑制性血清蛋白浓度高和磷脂酰胆碱百分比低，再灌注反应期间表面活性剂功能受损。
