Exterimental study on heart lung transplantation in monkey

使用日本猴进行原位心肺移植。出血是第一个问题，脱离体外循环很困难。通过技术改进，包括适当选择缝线，并使用另一只猴作为献血者，实现了止血，并且从ECC中脱离变得容易。再循环后出现肺不张、水肿、出血等并发症，导致PaO_2降低，呼吸机吸气压升高。所有病例均于撤机后6小时内死亡。在心脏和肺的切除和移植过程中，注意尽可能不接触肺，并使用东北大学报道的Ep3溶液来保护肺免受缺血引起的损伤。在移植过程中，冰沙也被用来冷却肺部。这些方法明显改善了ECC术后心肺功能，最长存活时间为44小时。在接下来的实验中，对移植的、去神经的心脏和肺中的排斥反应的早期检测和神经纤维的形态学方面进行了研究。左半肺原位移植，心脏植入腹部。移植后五天，移植支气管和心脏房室结中的神经纤维显示出几乎正常的胆碱酯酶活性。用组织化学方法和单克隆抗体检测排斥反应。

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.