Erasmus M E, Petersen A H, Hofstede G, Haagsman H P, Bambang Oetomo S, Prop J
Cardiopulmonary Surgery Department, University Hospital Groningen, The Netherlands.
Am J Respir Crit Care Med. 1996 Feb;153(2):665-70. doi: 10.1164/ajrccm.153.2.8564115.
An impaired function of alveolar surfactant can cause lung transplant dysfunction early after reperfusion. In this study it was investigated whether treatment with surfactant before reperfusion improves the immediate function of lung transplants and whether an improved transplant function was associated with an increase in alveolar surfactant components. Left lungs with 6-h (n = 8) or prolonged 20-h ischemia (n = 10) were transplanted syngeneically in rats. In both ischemia groups half of the lung transplants were treated with surfactant just before reperfusion. Lung function was measured during reperfusion for 1 h. Thereafter, the rats were killed and bronchoalveolar lavage was performed to measure alveolar surfactant components. We found that surfactant treatment improved the immediate function of lung transplants in parallel with a higher amount of total surfactant phospholipids, a higher percentage of the heavy subtype of surfactant, a normalized percentage of phosphatidylcholine, and a higher amount of endogenous surfactant protein A (SP-A). We conclude that surfactant treatment before reperfusion does improve the immediate lung transplant function in rats in association with an increase in alveolar surfactant components. More particularly, the amount of (endogenous) SP-A is thought to be crucial for the efficacy of surfactant treatment after lung transplantation.
肺泡表面活性物质功能受损可在再灌注后早期导致肺移植功能障碍。在本研究中，我们调查了再灌注前使用表面活性物质治疗是否能改善肺移植的即时功能，以及移植功能的改善是否与肺泡表面活性物质成分的增加有关。将经历6小时（n = 8）或延长至20小时缺血的左肺（n = 10）同基因移植到大鼠体内。在两个缺血组中，一半的肺移植在再灌注前用表面活性物质进行治疗。在再灌注期间测量肺功能1小时。此后，处死大鼠并进行支气管肺泡灌洗以测量肺泡表面活性物质成分。我们发现，表面活性物质治疗改善了肺移植的即时功能，同时总表面活性物质磷脂含量增加、表面活性物质重亚型百分比升高、磷脂酰胆碱百分比正常化以及内源性表面活性物质蛋白A（SP-A）含量增加。我们得出结论，再灌注前使用表面活性物质治疗确实能改善大鼠肺移植的即时功能，并伴有肺泡表面活性物质成分增加。更具体地说，（内源性）SP-A的量被认为对肺移植后表面活性物质治疗的疗效至关重要。
