Experimental study on size matching in a canine living-donor lobar lung transplant model
Experimental study on size matching in a canine living-donor lobar lung transplant model
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DOI：
10.1067/mtc.2002.117280
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发表时间：
2002-01-01
影响因子：
6
通讯作者：
Shimizu, N
中科院分区：
文献类型：
--
作者：
Fujita, T;Date, H;Shimizu, N
目的：为解决供体短缺的问题，活体肺移植取得了满意的效果。小移植物的使用有潜在的问题，因为它可能会导致肺动脉高压，导致肺水肿。本研究的目的是评估小移植物对早期肺功能的影响，并找出可接受的大小差异的预测因素。方法：使用17对不同供受者大小的杂种犬。测量体重、身高、胸围和肺重作为尺寸参数。在不使用体外循环的情况下，右中、下、心叶作为受体的右肺植入，左下叶作为左肺植入。结果：供、受者体重比与供、受者1h平均肺动脉压呈显著负相关(r=-0.594，P=0.025)。供受者体重比与术后6h PaO2呈显著正相关(r=0.704；P=0.007)。其余3个大小参数与术后肺功能无明显相关性。供受者体重比在1.2或以上的8例受者均在6小时内存活，6小时PaO2均超过500 mm Hg。结论：供受者体重比是犬活体肺移植模型早期肺功能的重要预测指标。
Objective: In an effort to address the donor-shortage issue, living-donor lobar lung transplants have been performed with satisfactory results. The use of small grafts is potentially problematic because it could cause high pulmonary artery pressure, resulting in lung edema. The purpose of this study was to evaluate the effect of small grafts on early pulmonary function and to identify the predictor for acceptable size discrepancy.Methods: Seventeen pairs of mongrel dogs with various donor-recipient sizes were used. Body weight, height, chest circumference, and lung weight were measured as size parameters. Right middle, lower, and cardiac lobes were implanted as a right lung of the recipient and the left lower lobe was implanted as a left lung without use of cardiopulmonary bypass. Pulmonary function of the recipient was measured for 6 hours after reperfusion.Results: A significant negative correlation was found between donor/recipient body-weight ratio and mean pulmonary artery pressure at 1 hour (r = -0.594, P = .025). A significant correlation was found between donor/recipient body-weight ratio and PaO2 at 6 hours (r = 0.704; P = .007). There was no significant correlation between the other 3 size parameters and postoperative pulmonary function. All 8 recipients with a donor/recipient body-weight ratio of 1.2 or greater survived the 6-hour assessment period, and their PaO2 exceeded 500 mm Hg at 6 hours.Conclusions: Donor/recipient weight ratio is an important predictor of early pulmonary function in a canine living-donor lobar lung transplant model.