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

背景以前的研究表明，在肺保存过程中维持有氧代谢的氧的可用性可能是保存的肺组织的最佳生存能力所必需的。本研究的目的是评估在兔模型中用氧合血对肺移植物进行最佳氧输送的肺保存。材料和方法。将18只切除的兔肺用以下溶液之一冲洗并在10 ℃下储存18小时：Euro-Collins溶液（EC ; n=6）、含氧同种血（OB ; n=6）或低钾右旋糖酐溶液（LPD ; n=6）。用离体血液灌注肺模型评价储存后肺功能10分钟。为了评估移植肺中中性粒细胞的募集和内皮细胞的损伤，通过ELISA检测血栓调节蛋白、E-选择素和内皮素。EC、OB、LPD组再灌注后10分钟的平均氧分压为47.0（± SY）。[)2.8<@D1**@> D1，76.9（]SY.+-. [）1 关于我们 3.1，96.2（]SY.+-.（）10.9mmHg（<@D1**@>D1p<0.05 vs OB，LPD）。EC再灌注期间的肺动脉压（35.8 ± 0.5kPa）。[)4.4 10 min时的mmHg）高于OB和LPD组（29.8 ± 0.1mmHg）。[)4.3，22.4（]SY. ±. [)2.2 mmHg）。而OB再灌注血中E-选择素（5.04 ± 0.05）μ g/ml，与对照组相比无显著性差异（P> 0.05）。[] 0.24 ng/ml）显著高于其他组（EC ; 3.56（]SY. ±-. [）0.54，LPD ; 2.92（]SY. ±. [0.35 ng/ml，p<0.05]，表明OB组中性粒细胞募集增强。三组之间的血栓调节素和内皮素的比较没有达到统计学意义。结论.我们的结论是，氧合血可以提高肺保存相比，欧洲柯林斯解决方案，可能是通过其丰富的氧气输送过程中的存储和细胞外成分。然而，由于增加的中性粒细胞募集可能激活嗜中性粒细胞-内皮细胞相互作用，因此可用性不超过LPD溶液。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