Kondo T, Fujimura S, Saito R, Matsumura Y, Ohura H, Hirose M, Sugita M, Sado T, Minowa M
Department of Thoracic Surgery, Tohoku University, Sendai, Japan.
Nihon Geka Gakkai Zasshi. 1996 Nov;97(11):997-1002.
Lung transplantation has been established as an optional treatment for variable irreversible diffuse lung diseases. To date, more than 5,000 patients have underwent lung transplantation, and nearly 1,000 procedures a year are performed recently. Although heart-lung transplantation has also been technically established, this procedure is confined to quite limited conditions due to the severe shortage of donors and many difficulties in operative procedure and the patient management. Preservation, post-transplantation edema, diagnosis of rejection, chronic rejection, shortage of donor organs, are principal problems in clinical lung transplantation, 24-hour preservation proved to be possible in several recent experimental studies, and the reperfusion injury has been revealed to be one of causes of post-transplantation edema. Establishment of methods for long-term pulmonary preservation and for the treatment of post-transplantation edema may be promising in the near future. Shortage of donor lung is one of major limiting factors. Research works on xenotransplantation and cadaver lung transplantation are on going, and these may help in solving this problem.
肺移植已被确立为治疗各种不可逆弥漫性肺部疾病的一种可选疗法。迄今为止，已有超过5000例患者接受了肺移植，且最近每年进行近1000例手术。尽管心肺移植在技术上也已确立，但由于供体严重短缺、手术操作和患者管理存在诸多困难，该手术仅限于非常有限的情况。保存、移植后水肿、排斥反应的诊断、慢性排斥反应、供体器官短缺，是临床肺移植的主要问题，最近的几项实验研究证明24小时保存是可行的，再灌注损伤已被揭示为移植后水肿的原因之一。建立长期肺保存方法和治疗移植后水肿的方法在不久的将来可能很有前景。供体肺短缺是主要限制因素之一。异种移植和尸体肺移植的研究工作正在进行，这些可能有助于解决这个问题。
