Bando T, Kosaka S, Liu C, Hirai T, Hirata T, Yokomise H, Yagi K, Inui K, Hitomi S, Wada H
Department of Thoracic Surgery, Kyoto University, Japan.
J Thorac Cardiovasc Surg. 1994 Jul;108(1):92-8.
Trehalose is a nonreducing disaccharide that stabilizes the cell membrane under various stressful conditions. A previous study demonstrated that trehalose was effective in 12-hour canine lung preservation. We have developed new preservation solutions containing trehalose: an extracellular type ET-Kyoto solution (Na 100 mmol/L, K 44 mmol/L) and an intracellular type IT-Kyoto solution (Na 20 mmol/L, K 130 mmol/L). The composition of these solutions is identical except for the electrolyte content. We examined their efficacy in 20-hour lung preservation. Canine lungs were flushed with ET-Kyoto (group A, n = 6), with IT-Kyoto and prostaglandin E1 (25 micrograms/kg) (group B, n = 6), or with Euro-Collins solution and prostaglandin E1 (25 micrograms/kg) (group C, n = 7), and stored for 20 hours at 4 degrees C. Left lung transplantation was performed and evaluated for up to 130 minutes. The flush time was similar in the three groups. Arterial oxygen tensions (inspired oxygen fraction = 0.5) in group A were uniformly excellent (303.3 +/- 7.0 mm Hg 70 minutes after reperfusion and 303.0 +/- 19.6 mm Hg 130 minutes after reperfusion) and significantly higher than in group B (202.6 +/- 32.0 mm Hg, p < 0.05, and 197.8 +/- 44.0 mm Hg, p = 0.054, respectively) or group C (185.9 +/- 23.0 mm Hg, p < 0.01, and 155.7 +/- 36.3 mm Hg, p < 0.05, respectively). Peak inspiratory pressure in group A was significantly lower than in groups B and C (p < 0.05). Wet/dry weight ratio in group A was significantly lower than in groups B (p < 0.05) and C (p < 0.01). Histologic and scanning electron microscopic examinations showed better preservation in group A than in groups B and C. We conclude that ET-Kyoto is superior to IT-Kyoto and to Euro-Collins solution for 20-hour lung preservation.
海藻糖是一种非还原性二糖，可在各种应激条件下稳定细胞膜。先前的一项研究表明，海藻糖在犬肺12小时保存中有效。我们开发了含海藻糖的新型保存液：一种细胞外型ET - 京都液（钠100毫摩尔/升，钾44毫摩尔/升）和一种细胞内型IT - 京都液（钠20毫摩尔/升，钾130毫摩尔/升）。除电解质含量外，这些溶液的成分相同。我们检测了它们在肺20小时保存中的效果。用ET - 京都液冲洗犬肺（A组，n = 6），用IT - 京都液和前列腺素E1（25微克/千克）冲洗（B组，n = 6），或用欧洲柯林斯液和前列腺素E1（25微克/千克）冲洗（C组，n = 7），并在4℃下保存20小时。进行左肺移植并评估长达130分钟。三组的冲洗时间相似。A组的动脉血氧分压（吸入氧分数 = 0.5）一直很优异（再灌注后70分钟为303.3±7.0毫米汞柱，再灌注后130分钟为303.0±19.6毫米汞柱），显著高于B组（分别为202.6±32.0毫米汞柱，p < 0.05，和197.8±44.0毫米汞柱，p = 0.054）或C组（分别为185.9±23.0毫米汞柱，p < 0.01，和155.7±36.3毫米汞柱，p < 0.05）。A组的吸气峰压显著低于B组和C组（p < 0.05）。A组的湿/干重比显著低于B组（p < 0.05）和C组（p < 0.01）。组织学和扫描电子显微镜检查显示A组的保存效果优于B组和C组。我们得出结论，对于肺20小时保存，ET - 京都液优于IT - 京都液和欧洲柯林斯液。
