Study of reimplantation response in lung transplantation

研究保存肺的生存能力，不仅可以建立最佳的保存方法，而且可以明确肺移植中不同于排斥反应的再植反应机制，器官中ATP水平的测定是缺血性损伤的指标之一。我们用高压液相色谱法（HPLC）测量了在室温（25℃）和低温（2-4℃）下切除的犬和人肺8小时内ATP水平的变化。原位ATP水平为5.4 <+！11只狗>.0 <mu> mol/g干重（D.W.）， 4.4 <+！-> 0.4 <mu> mol/g。10人患病。三磷酸腺苷水平随时间变化基本不变，保存温度无显著差异。然而，肝脏的水平从10.3 <+！-> 0.7 <mu> mol/g。D.W.至2.4-4.0 <mu> mol/g。15分钟内昏迷，低温疗法有效。在室温下保存8小时后，肺内ATP水平降至原位的1/6。肺泡中被困的空气可能有助于肺抵抗缺血，并解释了与肝脏的特定器官差异。这些结果表明，为了长期保存，有必要对肺组织进行保护。

The investigation of viability of preserved lungs is important, not only to establish the optimum preservation method, but also to make clear the mechanism of the reimplantation response which differs from rejection in lung transplantation Measurement of ATP levels in organs is applied as one of the indicators of ischemic injury. We measured changes in ATP levels by High Pressure Liquid Chromatography (HPLC) in resected canine and human lungs of room (25 degrees C) and hypothermal (2-4 degrees C) temperatures over an 8 hour period. The ATP levels in situ were 5.4 <+!-> 1.0 <mu> mol/g dry weight (D.W.) in 11 dogs and 4.4 <+!-> 0.4 <mu> mol/g. D.W. in 10 humans. The time course changes in ATP levels were almost constant, and there was no significant difference in preservative temperature. However levels in liver decrease from 10.3 <+!-> 0.7 <mu> mol/g. D.W. to 2.4-4.0 <mu> mol/g. D.W. within 15 minutes, and hypothermia is effective. ATP levels in deflated lungs kept at room temperature decreased to 1/6 those in situ in 8 hours. The trapped air in the alveolus may contribute to the lung's resistance to ischemia, and account for the specific organ differences from liver. These results suggest that it is necessary to protect lung tissue from atelactasis for long-term preservation.