Experimental investigation of heart-lung transplantation

本文报道了日本猕猴（Macaca fuscata）同种异体原位心肺移植、自体原位心肺移植和异位心脏移植的实验研究结果，其中8只猕猴存活3 ~ 33天。移植后呼吸模式发生明显改变，术后早期胸片显示中心混浊，间质改变增强，术后5 ~ 8d达高峰。病理学检查发现，该期肺内无明显圆形细胞浸润，2只猴出现心脏和肺的非同步排斥反应。1只猴出现中度心脏排斥反应和重度肺水肿，无明显圆形细胞浸润，1只猴出现血管型轻度肺排斥反应，无心脏排斥反应。 关于我们 供体气管的组织学检查显示，除2只猴出现鳞状上皮化生外，粘膜上皮无明显变化。然而，在每只猴中均观察到圆形细胞的粘膜下浸润。中、重度排斥反应组气管粘膜下细胞浸润程度高于轻度排斥反应组。术后胸部X线片显示术后早期支气管周围和血管周围袖状。显微镜下观察到支气管周围和血管周围水肿，无或仅有极少量圆形细胞浸润，并测定了同种异体心脏移植猴血浆肌球蛋白轻链（myosin light chain，MG）水平，对心脏移植排斥反应的监测有一定价值。少

Experimental evaluations were done in Japanese monkeys (macaca fuscata) about orthotopic heart-lung allotransplantation, orthotopic heart-lung autotransplantation, and heterotopic heart allotransplantation.In orthotopic heart-lung allotransplantation,eight recipient monkeys survived for three to thirty three days. Their respiratory pattern changed considerably after the transplantation.The chest roentogenogram in the early postoperative period showed the central cloudiness and enhancement of the interstitial change, alid these findings reached their peak between the fifth and eighth postoperative day. Pathological study revealed no obvious round cell infiltration in the lung of this stage.Asynchronous rejections of the heart and the lungs following the allotransplantation were observed in two monkeys. Moderate cardiac rejection and severe pulmonary edema without apparent round cell infiltration were observed in one monkey, and vascular type mild pulmonary rejection without cardiac reje … More ction was recognized in the etlier monkey.Histologic assessment of the donor trachea revealed that there was no significant change in the mucosal epithelium except for the squamous metaplasia which was observed in two monkeys. However,submucosal infiltration of round cell was observed in every monkey. The tracheas of allograft with moderate to severe rejection showed higher degrees of submoucosal cell infiltration than those with minimal to mild rejection.In the orthotopic heart-lung autotrazisplantation, seven monkeys survived two to five days. Postoperative chest roentogenogram showed peribronchial and perivascular cuffing in the early postoperative period. Peribronchial and perivascular edema without or with minimal round cell infiltration was observed microscopically.Measurement of the plasma myosin light chain level was done in the monkeys which were subjected to heterotopic cardiac allotransplantation,and it revealed to be of value in the monitoring of cardiac allograft rejection. Less