Sohn K H, Song M G, Lee J M, Song K S, Moon D H, Yu E S, Kim W D
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Songpa-Ku, Seoul, Korea.
J Korean Med Sci. 1993 Jun;8(3):171-9. doi: 10.3346/jkms.1993.8.3.171.
An assessment of early graft function in canine single lung transplant recipients was made by analysing early postoperative radiographic progression, lung perfusion, bronchial patency and bronchial anastomotic wound healing and histopathology of the allografted lung. Eighteen mongrel dogs weighing 15kg on average were used. Donor lung bloc with a generous atrial cuff, the pulmonary artery and left bronchus were taken and flushed with Euro-Collins solution which implanted in the pneumonectomized recipient dog. Anastomosis was done with the atrium, pulmonary artery and bronchus in that order. To assess an early graft function, a protocol for a grading system was designed into the chest roentgenogram, lung perfusion scan, bronchial patency and histopathologic progression of the bronchial anastomosis and allografted lung (Table 1). The results were obtained as follows: Radiographically, clear to infiltrate was seen in 67% (8/12), 33% (5/15), 30% (3/10) and 33% (2/6) on postoperative day 0, 1, 2 and 3 respectively. Lobar to total opacification was 33% (4/12), 67% (10/15), 70% (7/10) and 67% (4/6) on days 0 to 3 (Table 2). Perfusion scan showed normal to mild defect in 43% (3/7) and moderate to severe defect in 57% (4/7) on day 0 and 100% (5/5) on day 2 (Table 3). The bronchial anastomotic site showed patent to mild stenosis in 100% (8/8) on day 0 and mild stenosis in 2/2 on day 9 bronchofiberscopically, and showed normal wound healing in 38% (3/8), cellular infiltration in 38% (3/8) and infarction in 25% (2/8) up to day 9 postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)
通过分析犬单肺移植受者术后早期的影像学进展、肺灌注、支气管通畅情况、支气管吻合口愈合以及移植肺的组织病理学,对早期移植肺功能进行了评估。平均体重为15千克的18只杂种犬被用于实验。获取带有宽大心房袖套、肺动脉和左支气管的供肺块,并用Euro - Collins溶液冲洗后植入接受肺切除的受体犬体内。按心房、肺动脉和支气管的顺序进行吻合。为评估早期移植肺功能,设计了一个分级系统方案,用于胸部X线片、肺灌注扫描、支气管通畅情况以及支气管吻合和移植肺的组织病理学进展评估(表1)。结果如下:影像学方面,术后第0、1、2和3天,分别有67%(8/12)、33%(5/15)、30%(3/10)和33%(2/6)的情况表现为清晰至浸润;第0至3天,肺叶至全肺实变分别为33%(4/12)、67%(10/15)、70%(7/10)和67%(4/6)(表2)。灌注扫描显示,第0天43%(3/7)为正常至轻度缺损,57%(4/7)为中度至重度缺损;第2天100%(5/5)为中度至重度缺损(表3)。支气管吻合部位在术后第0天经支气管纤维镜检查显示100%(8/8)通畅至轻度狭窄,第9天2/2为轻度狭窄;术后第9天,38%(3/8)显示伤口愈合正常,38%(3/8)有细胞浸润,25%(2/8)有梗死。(摘要截断于250字)