Multiple basic research for clinical application of the heart and heart-lung transplantation

心脏及心肺移植临床应用多项基础研究

• 批准号: 61480299
• 负责人: KOYANAGI Hitoshi
• 金额: $ 3.84万
• 依托单位: Tokyo Women's Medical College
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (B)
• 财政年份: 1986
• 资助国家: 日本
• 起止时间: 1986 至 1987
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-61480299/
• 关键词: Orthotopic Heart Transplantation; Pressure-Volume Curve; Acute Rejection; Electrophysiologic Montoring; Single Lung Transplantation; Pulmonary Hypertension; Heart-Lung Transplantation; 心肺移植; 圧客積曲線; 収縮形態の変化; 同所性心移殖; 異所性心移殖; 電気生理学的検討; 病理組織学的検討

Four studies were undertaken to evaluate major problems in heart or heart-lung transplantation.1. It was important for experimental orthotopic heart transplantation to avoid the hemolysis by appropriate blood transfusion and prevent the lung edema under blood priming-middle flow cardiopulmonary bypass. The end-systolic pressure/end-systolic volume ratio of donor hearts decreased immediately after the transplantation. There was no change in the conductivity and refractoriness of the transplanted heart during early postoperative period. We made our own practical manual about the technique of harvest, preservation and orthotopic transplantation of a donor heart and the perioperative care of a recipient.2. Electrophysiologic assessment of the transplanted canine heart disclosed that the prolongation of effective refractory period of the atrio-ventricular conduction system had significant sensitivity for cell infiltration in the conduction system. These results suggested the feasibility of electrophysiologic monitoring as a means for detecting acute rejection in the pre-necrotic stage in transplanted hearts.3. Pulmonary flow-resistance relationships in canine allograft single lung transplantation showed that the allografts, of which water content remained within twice the normal, could tolerate well the normal range of pulmonary blood flow. These results implied that single lung transplantation could be an effective treatment for pulmonary hypertension.4. The lungs after four hours preservation with a heart had better total compliance and lesser damage of air-blood-barrier in the artificial surfactant-treated group than in the unteated group. These facts suggested that the artificial surfactant supplement may provide a favorable effect on the lung preservation in heart-lung transplantation.

进行了四项研究来评估心脏或心肺移植中的主要问题。在血液预充-中流量体外循环下，适当输血避免溶血和防止肺水肿是原位心脏移植的重要环节。供心移植后即刻收缩末期压/收缩末期容积比下降。术后早期移植心脏的传导性和不应性无明显变化。我们自己编写了实用手册，介绍了供体心脏的获取、保存和原位移植技术以及围手术期的护理。移植犬心脏的电生理检查结果表明，房室传导系统有效不应期的延长对传导系统的细胞浸润具有明显的敏感性。这些结果表明，电生理监测作为检测移植心脏坏死前急性排斥反应的一种手段是可行的.犬同种异体单肺移植的肺血流-阻力关系表明，移植肺含水量在正常范围的2倍以内，移植肺能较好地耐受正常范围的肺血流。提示单肺移植是治疗肺动脉高压的有效方法.人工表面活性剂处理组与未处理组相比，保存4小时后的肺总顺应性较好，气-血屏障损伤较轻。这些事实表明，人工表面活性物质的补充可能会提供良好的效果，在心肺移植肺保存。

项目成果

Kiyoyuki,Eishi,MD, Arifumi,Takazawa,MD, Toshiki,Doi,MD, Kinya,Hirata,MD, Masaaki,Yamagishi,MD, Masayoshi,Nagatsu,MD, Eisaburo,Imamura,MD, Hitoshi,Koyanagi,MD: "Unilateral lung transplantation in dogs; a possible palliation of advanced pulmonary hypertensi

Kiyoyuki，Eishi，MD，Arifumi，Takazawa，MD，Toshiki，Doi，MD，Kinya，Hirata，MD，Masaaki，Yamagishi，MD，Masayoshi，Nagatsu，MD，Eisaburo，Imamura，MD，Hitoshi，小柳，MD：“单边

Masaya Kitamura, et al.: The Journal of Heart Transplantation. 7(3). (1988)

Masaya Kitamura 等人：《心脏移植杂志》。

Masaya,Kitamura,MD, Naohide,Sakakibara,MD, Hiromi,Kurosawa,MD, Eisaburo,Imamura,MD, Hiroshi,Kasanuki,MD, Morie,Sokiguchi,MD, Hitoshi,Koyanagi,MD: "Electrophysiologic assessment of the transplanted canine heart; correspondence to histopathologic findings i

Masaya,Kitamura,MD, Naohide,Sakakibara,MD, Hiromi,Kurosawa,MD, Eisaburo,Imamura,MD, Hiroshi,Kasanuki,MD, Morie,Sokiguchi,MD, Hitoshi,Koyanagi,MD：“移植犬心脏的电生理学评估

Masaya,Kitamura,MD: "Electrophysiological and histopathological evaluation of the transplanted canine hearts; possibility for electrophysiological monitoring of acute rejection" The Journal of the Japanese Association for Thoracic Surgery. 36(6). (1988)

Masaya，Kitamura，医学博士：“移植犬心脏的电生理学和组织病理学评估；急性排斥反应电生理学监测的可能性”日本胸外科协会杂志。

北村昌也: 日本胸部外科学会雑誌. 36(6). (1988)

Masaya Kitamura：日本胸外科杂志 36(6) (1988)。