Evaluation of the initial lung flushing with oxygenated blood on the adequacy of lung preservation.

背景。先前的研究表明，在肺保存过程中，氧气的可用性以维持有氧代谢可能对保存肺组织的最佳活力至关重要。本研究的目的是评估含氧血在兔肺移植模型中的肺保存效果。材料和方法。将18只切除的兔肺冲洗，并在10‰的温度下保存18小时；Euro-Collins溶液（EC, n=6），氧合同源血（OB, n=6），或低钾葡聚糖溶液（LPD, n=6）。用离体血灌注肺模型观察10分钟后肺功能。采用elisa法检测血栓调节素、e -选择素、内皮素对移植肺中性粒细胞募集和内皮细胞损伤的影响。再灌注开始后10分钟，EC、OB、LPD组的平均氧张力为47.0（p < 0.05）。(2.8) < @D1 * * @ > D1, SY。+ - 76.9()。(1) ... 3.1, 96.2 (SY。+ -。)10.9毫米汞柱,分别(< @D1 * * @ > D1p < 0.05 vs OB, LPD)。再灌注期间EC组肺动脉压（10 min时35.8(]SY.+- . [)4.4 mmHg）高于OB组和LPD组(分别为29.8（]SY.+- .[)4.3、22.4(]SY.+- . [)2.2 mmHg）。但OB组再灌注血e -选择素（5.04(]SY.+- . [)0.24 ng/ml）显著高于其他组(EC组；3.56(]SY.+- . [)0.54， LPD组；0.35 ng/ml, p<0.05)，表明OB组中性粒细胞募集增强。三组间血栓调节素、内皮素比较无统计学意义。结论。我们得出结论，与Euro-Collins溶液相比，含氧血可能通过其在储存和细胞外成分中丰富的氧输送而增强肺保存。然而，可用性不超过LPD溶液，因为增加的中性粒细胞募集可能激活中性粒细胞-内皮细胞间噬细胞。少

Background. Previous studies have shown that availability of oxygen during lung preservation to maintain aerobic metabolism may be essential for the optimum viability of preserved lung tissue. The purpose of this study was to evaluate lung preservation with oxygenated blood for an optimum oxygen delivery to the lung graft in a rabbit model. Materials and methods. Eighteen excised rabbit lungs were flushed and stored for 18 hours at 10ﾟC with one of following ; Euro-Collins solution (EC ; n=6), oxygenated homologous blood (OB ; n=6), or low-potassium dextran solution (LPD ; n=6). Poststorage lung functions were evaluated with isolated, blood-perfused lung model for 10 minutes. For the assessment of neutrophil recruitment and endothelial cells injury in the lung graft, thrombomodulin, E-selectin, and endothelin were measured by the ELISA.Results. The mean oxygen tensions at 10 minutes after the onset of reperfusion for the EC,OB,LPD groups were 47.0(]SY.+-。[)2.8<@D1**@>D1,76.9(]SY.+-。[)1 … More 3.1,96.2(]SY.+-。[)10.9 mmHg, respectively (<@D1**@>D1p<0.05 vs OB,LPD). Pulmonary artery pressure during the reperfusion period in the EC (35.8(]SY.+-。[)4.4 mmHg at 10 min) was higher than that in the OB and LPD groups (29.8(]SY.+-。[)4.3,22.4(]SY.+-。[)2.2 mmHg, respectively). However, E-selectin in the reperfused blood in the OB (5.04(]SY.+-。[)0.24 ng/ml) was significantly elevated than in other groups (EC ; 3.56(]SY.+-。[)0.54, LPD ; 2.92(]SY.+-。[)0.35 ng/ml, p<0.05), which indicated an enhanced neutrophil recruitment in the OB group. Comparisons of thrombo-modulin and endothelin between the three groups did not reach a statistical significance. Conclusions. We conclude that oxygenated blood may enhance lung preservation as compared to Euro-Collins solution, probably through its enriched oxygen delivery during storage and extracellular composition. However, the availability does not exceed LPD solution because of augmented neutrophil recruitment which may activate neutrophil-endothelial interacrions. Less