Kern J A, Kron I L, Flanagan T L, Binns O A, Scott W W, Chan B B, Zografakis J G, Tribble C G
Department of Surgery, University of Virginia Health Sciences Center, Charlottesville 22908.
J Heart Lung Transplant. 1993 Jan-Feb;12(1 Pt 1):34-40; discussion 40-1.
Reimplantation or allotransplantation of the immature porcine left lower lobe results in long-term functional dynamic airway obstruction that is associated with abnormally small distal airways. We have attributed this small airway size to bronchoconstriction resulting from chronic denervation rather than to impaired airway growth. To further investigate these findings, we transplanted mature left lower lobes from adult pigs into young piglets after left pneumonectomy. After approximately 12 weeks of somatic growth, the lobes were harvested and fixed through the airways with formalin. Cross-sectional areas of terminal, noncartilaginous airways from the lung periphery were traced on a video monitor. Five groups were examined: control innervated mature left lower lobes, innervated left lower lobes subjected to compensatory growth after left upper lobectomy at approximately 9 weeks of age, mature left lower lobe transplants, reimplanted immature left lower lobe autografts, and transplanted immature left lower lobe allografts. Unlike the immature porcine lobe, transplantation of the mature porcine lobe does not result in abnormally small airways. The small airways seen after transplantation or reimplantation of the immature porcine lobe are likely, therefore, to be due to impaired airway development and not to bronchoconstriction caused by denervation.
未成熟猪左下叶的再植入或同种异体移植会导致长期功能性动态气道阻塞，这与远端气道异常狭小有关。我们将这种气道狭小归因于慢性去神经支配导致的支气管收缩，而非气道生长受损。为进一步研究这些发现，我们在小猪左侧肺切除术后，将成年猪的成熟左下叶移植到小猪体内。经过约12周的躯体生长后，取出肺叶并通过气道用福尔马林固定。在视频监视器上描绘肺周边终末非软骨性气道的横截面积。研究了五组：对照的有神经支配的成熟左下叶、约9周龄时左上叶切除后经历代偿性生长的有神经支配的左下叶、成熟左下叶移植、再植入的未成熟左下叶自体移植以及移植的未成熟左下叶同种异体移植。与未成熟猪肺叶不同，成熟猪肺叶的移植不会导致气道异常狭小。因此，未成熟猪肺叶移植或再植入后出现的小气道可能是由于气道发育受损，而非去神经支配引起的支气管收缩。
