Miyatake T
Second Department of Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
Hokkaido Igaku Zasshi. 1994 Jan;69(1):35-45.
Changes in cardiac function during hyperacute rejection are not fully understood because of lack of appropriate models. In this study, a blood-perfused, isolated, supported heart model was employed for the analysis of cardiac function in discordant heart xenografts.
Experiment 1: Changes in left ventricular end-systolic pressure (LVESP) and coronary perfusion pressure (CPP) were measured for 120 min. Dry heart weight after perfusion was measured in the following 4 groups: group A; isolated rat heart perfused with blood from support rat, group B; guinea pig heart, support guinea pig, group C; guinea pig heart, support rat, and group D; guinea pig heart, support rat with cobra venom factor (CVF) pretreatment. Complement C3 of support rat serum in group C and group D was measured by single radial immunodiffusion (SRID). Experiment 2: Fifteen guinea pig hearts perfused with blood from untreated support rats were analyzed for correlation between survival time and LVESP, and CPP as well.
In groups A and B, LVESP and CPP was stable up to 120 min. In group C, 4 out of 6 hearts were stopped beating within 120 min. The difference between LVESP at 10 min in group C and that in group B was not obtained, possibly due to high variation of values in group C, whereas CPP in group C was higher than that in group B (p < 0.05). In group D, CVF was shown to deplete complement C3. Group D showed constant LVESP and CPP, similar to non-xenograft groups. Dry heart weight of group C was larger than those of group B and D. There were positive correlations between survival time and LVESP at 10 min, and increasing rate of LVESP after 10 min as well. A negative correlation between survival time and CPP at 10 min was observed, while no correlation was obtained between survival time and increasing rate of CPP after 10 min.
由于缺乏合适的模型，超急性排斥反应期间心脏功能的变化尚未完全了解。在本研究中，采用血液灌注、离体、支持心脏模型来分析不同种属心脏异种移植中的心脏功能。
实验1：测量左心室收缩末期压力（LVESP）和冠状动脉灌注压力（CPP）120分钟的变化。在以下4组中测量灌注后的心脏干重：A组；用支持大鼠的血液灌注的离体大鼠心脏，B组；豚鼠心脏，支持豚鼠，C组；豚鼠心脏，支持大鼠，以及D组；豚鼠心脏，支持经眼镜蛇毒因子（CVF）预处理的大鼠。通过单向放射免疫扩散法（SRID）测量C组和D组中支持大鼠血清的补体C3。实验2：分析15个用未经处理的支持大鼠的血液灌注的豚鼠心脏的存活时间与LVESP和CPP之间的相关性。
在A组和B组中，LVESP和CPP在120分钟内保持稳定。在C组中，6个心脏中有4个在120分钟内停止跳动。C组10分钟时的LVESP与B组之间未获得差异，可能是由于C组的值变化较大，而C组的CPP高于B组（p<0.05）。在D组中，CVF显示可消耗补体C3。D组显示LVESP和CPP恒定，与非异种移植组相似。C组的心脏干重大于B组和D组。存活时间与10分钟时的LVESP以及10分钟后的LVESP增加率之间存在正相关。观察到存活时间与10分钟时的CPP之间存在负相关，而存活时间与10分钟后的CPP增加率之间未获得相关性。
1）异种移植组中LVESP降低和CPP升高被认为是由于超急性排斥反应。2）这些变化可通过消耗C3来消除。3）在某些情况下，即消耗C3时，豚鼠心脏在异种移植条件下可如在同种异体移植条件下一样良好工作。4）血液灌注、离体、支持心脏模型对于分析不同种属异种移植中的心脏功能很有用。
