Okabayashi K, Aoe M, DeMeester S R, Cooper J D, Patterson G A
Department of Surgery, Washington University School of Medicine, Barnes Hospital, St. Louis, Missouri 63110.
Ann Thorac Surg. 1994 Jul;58(1):50-6. doi: 10.1016/0003-4975(94)91071-5.
Early graft dysfunction remains a significant problem in clinical lung transplantation. Pentoxifylline, a methylxanthine derivative, has been shown to have various beneficial effects on neutrophil-induced lung injury. We investigated effects of pentoxifylline on early posttransplantation lung function in a canine allograft model. Ten dogs underwent left lung allotransplantation. Donor lungs were flushed with modified Euro-Collins solution (50 mL/kg) and stored in an inflated state for 18 hours at 1 degrees C. In five experiments (group I), pentoxifylline was added to the flush and storage solutions (200 mg/L) at the time of harvest. The recipient animals received pentoxifylline (20 mg/kg intravenously) before reperfusion followed by pentoxifylline (0.1 mg.kg-1.min-1 intravenously) during the 6-hour posttransplantation assessment period. In group II, donors and recipients received no pentoxifylline. To evaluate only allograft function, the right main pulmonary artery and bronchus were ligated immediately after implantation. For 6 hours thereafter hemodynamics and gas exchange were assessed at 15-minute intervals while the animal was ventilated at an inspired oxygen fraction of 1.0. After 1 hour of assessment there was a significant difference in gas exchange between the groups, which persisted until the end of the study. By the end of the 6-hour assessment, the mean arterial oxygen tension was 236.7 mm Hg for group I versus 101.1 mm Hg for group II (p < 0.01), and the alveolar-arterial oxygen difference was 443.1 mm Hg versus 562.2 mm Hg (p < 0.015). Hemodynamics were not different between groups.(ABSTRACT TRUNCATED AT 250 WORDS)
早期移植肺功能障碍仍是临床肺移植中的一个重大问题。己酮可可碱是一种甲基黄嘌呤衍生物，已被证明对中性粒细胞诱导的肺损伤具有多种有益作用。我们在犬同种异体移植模型中研究了己酮可可碱对移植后早期肺功能的影响。10只犬接受了左肺同种异体移植。供体肺用改良的Euro-Collins溶液（50 mL/kg）冲洗，并在1℃下充气保存18小时。在5个实验（I组）中，收获时将己酮可可碱添加到冲洗液和保存液中（200 mg/L）。受体动物在再灌注前接受己酮可可碱（20 mg/kg静脉注射），然后在移植后6小时的评估期内接受己酮可可碱（0.1 mg·kg-1·min-1静脉注射）。在II组中，供体和受体未接受己酮可可碱。为了仅评估同种异体移植功能，植入后立即结扎右主肺动脉和支气管。此后6小时内，每隔15分钟评估一次血流动力学和气体交换，同时动物以1.0的吸入氧分数通气。评估1小时后，两组之间的气体交换存在显著差异，该差异一直持续到研究结束。到6小时评估结束时，I组的平均动脉血氧分压为236.7 mmHg，而II组为101.1 mmHg（p < 0.01），肺泡-动脉氧分压差为443.1 mmHg对562.2 mmHg（p < 0.015）。两组之间的血流动力学无差异。（摘要截断于250字）
