Luo W, Cheng S, Jiang H
Department of Thoracic Cardiovascular Surgery, Xiangya Hospital, Hunan Medical University, Changsha.
Hunan Yi Ke Da Xue Xue Bao. 1997;22(3):195-8.
The authors examined the effects of ischemic preconditioning on lung preservation using a canine single left lung transplantation. Twelve adult mongrel dogs underwent left lung allotransplantation. Donor lungs were perfused and flushed with cold Euro-Collins solution (ECS) and stored at 4 degrees C ECS for 2 hours. Six donors were preconditioned by occuluding left lung hilum for 10 minutes and releasing for 15 minutes before flushing (Group PC); other six donors without ischemic preconditioning served as the controls (Group C). Left inferior pulmonary vein blood gas analysis, mean pulmonary artery pressure measurement and donor lung histology examination were made to evaluate the function of transplanted lung after transplantation. Oxygen tension at 2 hrs after reperfusion were significantly better in Group PC than in Group C (431 +/- 130 mmHg vs 246 +/- 66 mmHg, P < 0.05); mean pulmonary artery pressure was much lower in Group PC than in Group C after reperfusion (20.6 +/- 1.3 mmHg vs 36.9 +/- 3.1 mmHg, P < 0.01). Histological findings showed less injury in Group PC. These indicate that ischemic preconditioning combined with cold ECS perfusion is superior to cold ECS perfusion alone in canine lung preservation of 3 hours ischemia with 2 hours reperfusion.
作者利用犬类单左肺移植研究了缺血预处理对肺保存的影响。12只成年杂种犬接受了左肺同种异体移植。供体肺用冷的欧洲柯林斯溶液(ECS)灌注和冲洗,并在4℃的ECS中保存2小时。6只供体在冲洗前通过阻断左肺门10分钟然后松开15分钟进行预处理(预处理组);其他6只未经缺血预处理的供体作为对照组(对照组)。进行左下肺静脉血气分析、平均肺动脉压测量和供体肺组织学检查以评估移植后移植肺的功能。再灌注2小时后的氧分压在预处理组明显优于对照组(431±130mmHg对246±66mmHg,P<0.05);再灌注后预处理组的平均肺动脉压远低于对照组(20.6±1.3mmHg对36.9±3.1mmHg,P<0.01)。组织学结果显示预处理组损伤较轻。这些表明在犬类肺保存3小时缺血和2小时再灌注中,缺血预处理联合冷ECS灌注优于单独冷ECS灌注。