Albes J M, Klenzner T, Kotzerke J, Thiedemann K U, Schäfers H J, Borst H G
Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Germany.
Ann Thorac Surg. 1994 Feb;57(2):444-9. doi: 10.1016/0003-4975(94)91015-4.
Ischemic airway complications after lung transplantation remain a significant problem despite the use of bronchial omentopexy. Clinical observations suggest that enhancement of vascular ingrowth could possibly increase the efficacy of a bronchial omental flap. This study was therefore designed to investigate whether basic fibroblast growth factor can enhance blood supply of an ischemic airway by acceleration of vascular ingrowth in a rabbit autotransplant model. Segments of the trachea were harvested and transplanted into a subcutaneous pouch. The animals were randomly assigned to one of four groups: group I, no omentopexy; group II, omentopexy; group III, omentopexy and fibrin glue; or group IV, omentopexy and fibrin glue enriched with 2.5 micrograms basic fibroblast growth factor. After 14 days the animals were sacrificed. The extent of perfusion was investigated by means of radioactive microspheres. The morphology of the tracheal segments was investigated in a blinded fashion macroscopically, by means of light microscopy, and by means of scanning electron microscopy. The radioactivity measurements revealed a significantly increased perfusion of group IV (77% +/- 42%) as compared with groups I (17% +/- 13%) and III (20% +/- 16%). By macroscopic and light microscopic assessment, the epithelial integrity of group IV was significantly improved compared with groups I and II. At electron microscopy the integrity of group IV was significantly superior to all remaining groups. We conclude that a deposit of basic fibroblast growth factor and fibrin glue appears to increase revascularization of an ischemic airway from omentum and thus results in improved epithelial preservation of a tracheal autograft.
尽管采用了支气管网膜固定术，但肺移植术后缺血性气道并发症仍然是一个重大问题。临床观察表明，促进血管向内生长可能会提高支气管网膜瓣的疗效。因此，本研究旨在探讨碱性成纤维细胞生长因子是否能通过加速兔自体移植模型中的血管向内生长来增强缺血气道的血液供应。获取气管段并将其移植到皮下袋中。动物被随机分为四组之一：第一组，不进行网膜固定术；第二组，网膜固定术；第三组，网膜固定术加纤维蛋白胶；或第四组，网膜固定术加富含2.5微克碱性成纤维细胞生长因子的纤维蛋白胶。14天后处死动物。通过放射性微球研究灌注程度。气管段的形态通过宏观、光学显微镜和扫描电子显微镜以盲法进行研究。放射性测量显示，与第一组（17%±13%）和第三组（20%±16%）相比，第四组的灌注显著增加（77%±42%）。通过宏观和光学显微镜评估，与第一组和第二组相比，第四组的上皮完整性显著改善。在电子显微镜下，第四组的完整性明显优于所有其他组。我们得出结论，碱性成纤维细胞生长因子和纤维蛋白胶的沉积似乎增加了网膜对缺血气道的再血管化，从而改善了气管自体移植的上皮保存。
