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使用低钾右旋糖酐溶液进行肺保存后,肺移植后的脂质过氧化和缺血再灌注损伤减轻。

Reduced lipid peroxidation and ischemia-reperfusion injury after lung transplantation using low-potassium dextran solution for lung preservation.

作者信息

Sakamaki F, Hoffmann H, Müller C, Dienemann H, Messmer K, Schildberg F W

机构信息

Department of Surgery and Institute for Surgical Research, Klinikum Grosshadern, Ludwig-Maximilians-Universität München, Munich, Germany.

出版信息

Am J Respir Crit Care Med. 1997 Oct;156(4 Pt 1):1073-81. doi: 10.1164/ajrccm.156.4.9607109.

Abstract

Ischemia-reperfusion injury is one of the significant problems in clinical lung transplantation. We investigated the effect of lung preservation with Euro-Collins solution (EC group) or low-potassium dextran solution (LPD group) on lipid peroxidation and ischemia-reperfusion injury in a pig model of lung allotransplantation. The donor lungs were preserved at 4 degrees C for 18 h. Left-sided single lung transplantation was performed, followed by 6 h of reperfusion. Lipid peroxidation was measured as thiobarbituric acid-reactive materials (TBARM) in bronchoalveolar lavage (BAL) fluid and effluent solutions from pulmonary artery (Effluent). After 18 h of ischemia, the LPD group showed lower TBARM in BAL and Effluent than the EC group (p < 0.05). After ischemia plus reperfusion, lung wetto-dry weight ratios and TBARM levels in BAL in the LPD group were lower than those of the EC group (p < 0.05). Lung wet-to-dry weight ratios correlated with TBARM levels in BAL (p < 0.05, r = 0.50). We conclude lipid peroxidation in BAL and Effluent may reflect the degree of ischemia-reperfusion injury, and lung preservation with LPD can reduce lipid peroxidation and lung injury as compared with EC.

摘要

缺血再灌注损伤是临床肺移植中的重大问题之一。我们在猪同种异体肺移植模型中研究了用欧洲柯林斯液(EC组)或低钾右旋糖酐溶液(LPD组)进行肺保存对脂质过氧化和缺血再灌注损伤的影响。供体肺在4℃保存18小时。进行左侧单肺移植,然后再灌注6小时。脂质过氧化以支气管肺泡灌洗(BAL)液和肺动脉流出液(流出液)中的硫代巴比妥酸反应性物质(TBARM)来衡量。缺血18小时后,LPD组BAL和流出液中的TBARM低于EC组(p<0.05)。缺血加再灌注后,LPD组的肺湿干重比和BAL中的TBARM水平低于EC组(p<0.05)。肺湿干重比与BAL中的TBARM水平相关(p<0.05,r=0.50)。我们得出结论,BAL和流出液中的脂质过氧化可能反映缺血再灌注损伤的程度,与EC相比,用LPD进行肺保存可减少脂质过氧化和肺损伤。

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