Yoon H E, Mizuta T, Minami M, Fujii Y, Matsumura A, Nakahara K, Matsuda H
First Department of Surgery, Osaka University Medical School, Japan.
J Heart Lung Transplant. 1996 Jun;15(6):605-11.
After single lung transplantation for pulmonary hypertension, large mismatches in ventilation/perfusion distribution persist late after transplantation. The larger graft volume of the transplanted lung after transplantation, the better the exercise performance. Because the right lung is larger in volume than the left, we compared the left single lung transplant with the right single lung transplant regarding exercise performance with an animal model.
To simulate significant ventilation/perfusion imbalance observed after single lung transplantation for pulmonary hypertension, we transplanted isogenic left or right pulmonary grafts to normal rats, and the contralateral pulmonary artery was ligated 2 weeks after transplantation. The treadmill test was performed weekly until 6 weeks after transplantation to measure maximum tolerated running speed and maximum oxygen uptake.
Graft vital capacity of left and right pulmonary grafts were 4.5 +/- 0.43 ml (37% +/- 3.7% of recipient's predicted vital capacity) and 7.8 +/- 0.34 ml (63% +/- 2.4%), respectively (p < 0.01). Maximum tolerated speeds of left and right single lung transplants were 8 +/- 7.6 and 29 +/- 2.2 m/min, respectively, at 6 weeks after transplantation (p < 0.01). Maximal oxygen uptake values of left and right single lung transplants were 34 +/- 12.0 and 65 +/- 3.8 ml/kg/min, respectively (p < 0.01).
Results suggest that right lung transplantation is superior to left lung transplantation for pulmonary hypertension in terms of exercise performance in this animal model.
肺动脉高压患者接受单肺移植后,移植后期通气/灌注分布仍存在较大不匹配。移植后移植肺的体积越大,运动能力越好。由于右肺体积大于左肺,我们用动物模型比较了左单肺移植和右单肺移植的运动能力。
为模拟肺动脉高压患者单肺移植后出现的明显通气/灌注失衡,我们将同基因的左或右肺移植到正常大鼠体内,并在移植后2周结扎对侧肺动脉。每周进行一次跑步机测试,直至移植后6周,以测量最大耐受跑步速度和最大摄氧量。
左、右肺移植的移植肺肺活量分别为4.5±0.43 ml(占受体预计肺活量的37%±3.7%)和7.8±0.34 ml(占受体预计肺活量的63%±2.4%)(p<0.01)。移植后6周,左、右单肺移植的最大耐受速度分别为8±7.6和29±2.2 m/min(p<0.01)。左、右单肺移植的最大摄氧量分别为34±12.0和65±3.8 ml/kg/min(p<0.01)。
结果表明,在该动物模型中,就运动能力而言,右肺移植治疗肺动脉高压优于左肺移植。