Exterimental study on heart lung transplantation in monkey

原位心肺移植是用日本猴子进行的。出血是第一个麻烦，从体外循环中脱机是困难的。通过选择合适的缝线和使用另一只猴子作为献血者等技术改进，止血得以实现，脱离ECC变得容易。其次是肺功能恶化，再循环后即刻出现肺不张、水肿、出血，导致PaO2降低，呼吸机吸气压升高。所有病例均在ECC脱机后6小时内死亡。心肺切除和移植时尽量不接触肺，应用东北大学报道的EP3液保护肺免受缺血损伤。在移植过程中，冰块也被用来冷却肺部。ECC后心肺功能明显改善，存活时间最长为44小时。在接下来的实验中，对移植的失神经心脏和肺的早期排异反应的检测和神经纤维的形态进行了研究。移植后5天，移植支气管区和心房室结内的神经纤维显示接近正常的CH-E活动。用组织化学和单抗检测排斥反应。

Orthotopic heart-lung transplantation is performed using Japanese monkeys. Bleeding was the first trouble, and weaning from extracorporeal circulation was difficult. By technical improvement including the proper selection of sutures, and using of another monkey as a blood donor, hemostasis was achieved, and weaning from ECC became easy. Then the next trouble was the deterioration of lung.Atelectasis, edema, bleeding developed from just after recirculation, and resulted in the low PaO_2, elevation of inspiratory pressure of respirator. All cases died within 6 hours after weaning of ECC. Care was made not to touch the lungs as possible during resection and transplantation of heart and lungs, and Ep3 solution which was reported by Tohoku University was used to protect the lungs from injury caused by ischemia. Ice slush was also used to cool the lungs during transplantation. These procedures appearently improved the lungs condition of the heart and lungs after ECC, 44 hours was the longest survival time. Investigation of the early detection of rejection and the morphological aspects of nerve fibers in the transplanted, denervated heart and lungs were made by next experiments.Left hemi-lung was transplanted orthotopically, and the heart was implanted in the abdomen. Five days after transplantation, nerve fibers in the transplanted bronchus and atrio-ventricular node of the heart showed almost normal Ch-E activity. Investigation to detect the rejection was made by histochemistry and using the monoclonal antibody.