Hislop A A, Lee R J, McGregor C G, Haworth S G
Vascular Biology and Pharmacology Unit, Institute of Child Health, London, United Kingdom.
J Thorac Cardiovasc Surg. 1998 Mar;115(3):644-51. doi: 10.1016/s0022-5223(98)70330-7.
Shortage of donor organs for children has led to the use of living related adult lung lobar transplants. It is not known how these lobes or the recipient remaining lung grow after such transplants. The purpose of the present study was to assess lung growth in rat lungs up to 6 months after adult lobe transplantation into a juvenile recipient.
Right cardiac lung lobes from adult male Lewis rats were transplanted into the left hemithorax of juvenile (6-week-old) male Lewis rats after left pneumonectomy. Animals with appropriate controls were put to death 14 days and 6 months after transplantation. The lungs were fixed inflated and studied by means of quantitative morphometric techniques.
By 6 months after transplantation both the recipient right lung and the transplanted cardiac lobe were significantly larger than normal (p = 0.005; p = 0.001). In the recipient right lung this increase was due to an increase in the number of alveoli (p = 0.004) and in the transplanted cardiac lobe to an increase in size of the alveoli (p = 0.008).
An adult lobe transplanted into a young recipient is still viable and has normal architecture after 6 months, and growth of the recipients' own lung continues. The outlook for comparable transplants in children is promising, although the human condition can be complicated by rejection, infection, and treatment strategies.
儿童供体器官短缺导致了使用亲属活体肺叶移植。目前尚不清楚这些肺叶或受体剩余的肺在移植后如何生长。本研究的目的是评估成年肺叶移植到幼年受体后长达6个月的大鼠肺生长情况。
成年雄性Lewis大鼠的右心叶在左肺切除术后移植到幼年(6周龄)雄性Lewis大鼠的左半胸。移植后14天和6个月处死有适当对照的动物。肺固定充气后采用定量形态学技术进行研究。
移植后6个月,受体右肺和移植的心叶均明显大于正常(p = 0.005;p = 0.001)。受体右肺的这种增加是由于肺泡数量增加(p = 0.004),而移植的心叶则是由于肺泡大小增加(p = 0.008)。
移植到年轻受体中的成年肺叶在6个月后仍有活力且结构正常,受体自身肺的生长也在继续。尽管人类情况可能因排斥反应、感染和治疗策略而变得复杂,但儿童类似移植的前景是有希望的。