Shibuya K, Edagawa M, Takenaka H, Matsuzaki Y, Shibata K I, Onitsuka T, Koga Y, Hamada M
Second Department of Surgery, Miyazaki Medical College, Japan.
Transplantation. 1996 Jul 27;62(2):179-85. doi: 10.1097/00007890-199607270-00006.
We examined the efficacy of rinsing isolated lungs subjected to prolonged hypothermic storage with a high colloidal osmotic pressure solution prior to ex vivo blood reperfusion in order to preserve physiologic functions, suppress peroxidation of mitochondrial membranes, and inhibit infiltration of neutrophils. Isolated rabbit lungs were flushed with a Rinse-1 solution (289 mOsm/kg H2O) to remove remaining blood and immersed in physiologic saline at 8 degrees C for 24 hr. The control group received blood reperfusion immediately after storage; the Rinse-1 group was rinsed with Rinse-1 solution before blood reperfusion and the Rinse-2 group with Rinse-2 solution (312 mOsm/kg H20) including deferoxamine. Reperfused blood was passed through an artificial membranous lung to reduce oxygen tension (PO2) to the venous level, and time-dependent changes in airway pressure (AWP), pulmonary artery pressure (PAP), and PO2, as a measure of gas-exchange capability were examined. We estimated the lipid peroxide level in mitochondrial membranes as thiobarbituric acid-reactive substances (TBARS), i.e., malonedialdehyde, and neutrophil infiltration into lung tissue by measuring myeloperoxidase activity after 60 min of blood reperfusion. The PO2 was significantly higher in both rinsed groups compared with the control, while neither AWP nor PAP was significantly different in the three treatment groups. Both mitochondrial TBARS and myeloperoxidase activity were significantly higher in the control group compared with either rinsed group. These results indicate that rinsing stored lungs with a solution of high colloidal osmotic pressure prior to blood reperfusion was effective in preserving physiologic function and inhibiting neutrophil infiltration. Addition of deferoxamine was markedly effective in reducing TBARS formation and lessening reperfusion injury of stored lungs.
我们研究了在离体血液再灌注前，用高胶体渗透压溶液冲洗长时间低温保存的离体肺脏的效果，以保存其生理功能、抑制线粒体膜过氧化并抑制中性粒细胞浸润。将离体兔肺用冲洗液-1溶液（289 mOsm/kg H₂O）冲洗以去除残留血液，然后在8℃的生理盐水中浸泡24小时。对照组在保存后立即进行血液再灌注；冲洗液-1组在血液再灌注前用冲洗液-1溶液冲洗，冲洗液-2组用含去铁胺的冲洗液-2溶液（312 mOsm/kg H₂O）冲洗。再灌注血液通过人工膜肺以将氧分压（PO₂）降低至静脉水平，并检测气道压力（AWP）、肺动脉压力（PAP）和PO₂随时间的变化，以此作为气体交换能力的指标。我们将线粒体膜中的脂质过氧化物水平估算为硫代巴比妥酸反应性物质（TBARS），即丙二醛，并在血液再灌注60分钟后通过测量髓过氧化物酶活性来检测中性粒细胞向肺组织的浸润情况。与对照组相比，两个冲洗组的PO₂均显著更高，而三个治疗组的AWP和PAP均无显著差异。与任一冲洗组相比，对照组的线粒体TBARS和髓过氧化物酶活性均显著更高。这些结果表明，在血液再灌注前用高胶体渗透压溶液冲洗保存的肺脏可有效保存生理功能并抑制中性粒细胞浸润。添加去铁胺在减少TBARS形成和减轻保存肺脏的再灌注损伤方面具有显著效果。
