D'Armini A M, Lemasters J J, Egan T M
Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, USA.
Ann Thorac Surg. 1996 Nov;62(5):1448-53. doi: 10.1016/0003-4975(96)00628-5.
Prior studies from our laboratory have supported the use of cadaveric lungs for transplantation. In this study we investigated different preservation strategies for lungs retrieved from cadavers 4 hours after circulatory arrest.
Seventy-two Sprague-Dawley rats were sacrificed and then ventilated with 100% oxygen for 4 hours. The lungs were then flushed with modified Euro-Collins, University of Wisconsin, or Carolina rinse solution, either alone, with prostaglandin E1, or with prostaglandin E1 plus the free radical scavenger dimethylthiourea. After an additional 4-hour cold storage, the left lung was flushed with trypan blue solution to quantify cell viability, whereas the right lung was used to determine wet-to-dry weight ratios and to measure the levels of the adenine nucleotides adenosine triphosphate, adenosine diphosphate, and adenosine monophosphate by high-performance liquid chromatography.
Viability was consistently better in the lungs flushed with Carolina rinse solution; these differences were statistically significant compared with those in the corresponding modified Euro-Collins subgroups (p < 0.005). The addition of prostaglandin E1 to all three preservation solutions improved the total adenine nucleotide levels; this increase was statistically significant for the modified Euro-Collins subgroup (p < 0.005). The total adenine nucleotide levels for the University of Wisconsin subgroups were higher than those for the corresponding modified Euro-Collins subgroups. The highest total adenine nucleotide levels were obtained in lungs flushed with Carolina rinse plus prostaglandin E1. Wet-to-dry weight ratios were always significantly lower in the lungs preserved with University of Wisconsin solution (p < 0.05), with a value similar to that of fresh tissue.
The characteristics of the solution used to flush and to store rat cadaveric lungs have an impact on lung viability and adenine nucleotide metabolism. The ideal preservation strategy may allow for lung retrieval from cadavers for safe transplantation.
我们实验室之前的研究支持使用尸体肺进行移植。在本研究中,我们调查了循环停止4小时后从尸体获取的肺的不同保存策略。
处死72只Sprague-Dawley大鼠,然后用100%氧气通气4小时。随后用改良的欧洲柯林斯液、威斯康星大学液或卡罗来纳冲洗液冲洗肺,冲洗液可单独使用、与前列腺素E1联合使用或与前列腺素E1加自由基清除剂二甲基硫脲联合使用。再经过4小时的冷藏后,用台盼蓝溶液冲洗左肺以量化细胞活力,而右肺用于测定湿重与干重之比,并通过高效液相色谱法测量三磷酸腺苷、二磷酸腺苷和一磷酸腺苷等腺嘌呤核苷酸的水平。
用卡罗来纳冲洗液冲洗的肺的活力始终更好;与相应的改良欧洲柯林斯亚组相比,这些差异具有统计学意义(p < 0.005)。在所有三种保存液中添加前列腺素E1均可提高腺嘌呤核苷酸总量;改良欧洲柯林斯亚组的这种增加具有统计学意义(p < 0.005)。威斯康星大学亚组的腺嘌呤核苷酸总量高于相应的改良欧洲柯林斯亚组。用卡罗来纳冲洗液加前列腺素E1冲洗的肺中获得的腺嘌呤核苷酸总量最高。用威斯康星大学溶液保存的肺的湿重与干重之比始终显著更低(p < 0.05),其值与新鲜组织相似。
用于冲洗和储存大鼠尸体肺的溶液特性对肺活力和腺嘌呤核苷酸代谢有影响。理想的保存策略可能允许从尸体获取肺以进行安全移植。