Bhabra M S, Hopkinson D N, Shaw T E, Hooper T L
Department of Cardiothoracic Surgery, Wythenshawe Hospital, Manchester, United Kingdom.
Ann Thorac Surg. 1996 Nov;62(5):1494-9. doi: 10.1016/0003-4975(96)00498-5.
Modulation of vascular tone and platelet and neutrophil function through the prostaglandin/cyclic adenosine monophosphate or nitric oxide/cyclic guanosine monophosphate pathway can benefit lung graft function. The relative importance of these pathways is unclear.
Rat lung grafts (5 per group) were studied in an ex vivo reperfusion model. Group I grafts were pretreated with prostacyclin (20 ng.kg-1.min-1), flushed with cold Euro-Collins solution containing prostacyclin (200 micrograms/L), and reperfused immediately for 1 hour. Group II grafts were similarly procured but were stored at 4 degrees C for 6 hours before reperfusion. In group III, no prostacyclin therapy was used; instead, the nitric oxide donor glyceryl trinitrate (0.1 mg/mL) was added to the flush/storage solution, and the grafts were stored for 6 hours.
Group II grafts performed poorly compared with those in group I, with substantial deterioration of oxygenation and blood flow and elevation of pulmonary artery pressure, peak airway pressure, and wet to dry weight ratio. In contrast, graft function in group III was similar to that in controls.
Lung graft integrity after storage in Euro-Collins solution was better preserved by glyceryl trinitrate than by prostacyclin in this model.
通过前列腺素/环磷酸腺苷或一氧化氮/环磷酸鸟苷途径调节血管张力、血小板及中性粒细胞功能，可改善肺移植功能。这些途径的相对重要性尚不清楚。
在体外再灌注模型中研究大鼠肺移植（每组5个）。I组移植物用前列环素（20 ng·kg-1·min-1）预处理，用含前列环素（200μg/L）的冷Euro-Collins溶液冲洗，然后立即再灌注1小时。II组移植物的获取方式类似，但在再灌注前于4℃保存6小时。III组未使用前列环素治疗；而是在冲洗/保存溶液中加入一氧化氮供体硝酸甘油（0.1 mg/mL），移植物保存6小时。
与I组相比，II组移植物功能较差，氧合和血流显著恶化，肺动脉压、气道峰值压力及湿干重比升高。相比之下，III组移植物功能与对照组相似。
在此模型中，Euro-Collins溶液保存后，硝酸甘油比前列环素能更好地保存肺移植的完整性。
