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Exterimental study on heart lung transplantation in monkey

猴心肺移植的实验研究

基本信息

批准号：
61480298
负责人：
OGA Koichi
金额：
$ 4.29万
依托单位：
Kyoto Prefectural University of Medicine
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

项目摘要

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.

使用日本猴子进行原位心肺移植。出血是第一个问题，并且很难脱离体外循环。通过技术改进，包括正确选择缝合线，并使用另一只猴子作为供血者，实现了止血，并且很容易脱离ECC。接下来的麻烦是肺部的恶化。再循环后出现肺不张、水肿、出血，导致呼吸机PaO_2低，呼吸压力升高。所有病例均在停用ECC后6小时内死亡。在心肺切除和移植过程中尽量不接触肺，使用日本东北大学报道的Ep3溶液保护肺免受缺血损伤。在移植过程中，还使用冰泥来冷却肺部。这些方法明显改善了ECC后的心肺状况，最长存活时间为44小时。在接下来的实验中，我们对移植的失神经心脏和肺的早期排斥反应和神经纤维形态学方面进行了研究。左半肺原位移植，心脏植入腹部。移植后第5天，移植心肌支气管及房室结神经纤维Ch-E活性基本正常。采用组织化学和单克隆抗体检测排斥反应。