Lung Transplantation Using Primates Aiming Its Clinical Application.

在我们之前的大鼠肺移植检查中，支气管肺泡灌洗液（BALF）的检测被认为是监测排斥反应的良好诊断探针。为了保证该方法在临床应用中的有效性，我们对灵长类动物肺移植中的BALF进行了研究。对日本猕猴（Macaca fuscata）进行左肺同种异体移植。实验结果表明：1 .安氟醚与溴化环溴铵混合吸入麻醉对日本猴较好。在移植手术中，比在狗身上更需要轻柔的操作。免疫抑制给予环孢素（20mg/kg/d，肌内注射）和硫唑嘌呤（2.0mg/kg/d，皮下注射）。为了获得足够的免疫抑制，必须在移植前一周开始给予环孢素。支气管肺泡灌洗是通过支气管内注射和吸入10ml PBS， 3mm直径的支气管纤维镜楔入支气管基底支。BALF的变化与排斥反应进展的关系如下：1)总细胞数增加；2)淋巴细胞和中性粒细胞增多；3)T淋巴细胞亚群比（CD4/CD8）降低。结果与开放肺活检标本的组织学研究一致。这些结果表明，灵长类动物肺移植模型在技术上已经建立。BALF被证明是一种良好的诊断探针，用于监测灵长类动物的排斥反应。

In our previous examinations of rat lung transplantation,investigation of bronchoalveolar lavage fluid (BALF) was indicated as a good diagnostic probe for rejection monitoring. In order to assure the usefulness of this method in clinical application, the investigation of BALF in primate lung transplants was conducted. Left lung allotransplantation were performed in Japanese monkeys (Macaca fuscata). From these experiments, following results were obtained.l.Inhalation anesthesia by enflurane with pancronium bromide was preferable for Japanese monkey.2.In transplantation procedures, more gentle manipulations were necessary rather than in dogs.3.Immunosuppression was given by cyclosporine (20mg/kg/day,intramuscular injection) and azathioprine (2.0mg/kg/day,subcutaneous injection).To acquire enough immunosuppression, administration of cyclosporine was necessary start one week before the transplantation.4.The bronchoalveolar lavage was done by intrabronchial injection and aspiration of 10ml PBS with 3mm diameter bronchofiberscope wedged basal banch of bronchus.5.The changes of BALF associated with a progression of rejection were summarized as follows: 1)the number of total cells were increased; 2)lymphocytes and neutrophils were increased in number; and 3)T lymphocyte subset ratio (CD4/CD8) was decreased. The results were consistent with histological studies of specimens taken by open lung biopsies.From these results, it was shown that the primate lung transplantation model was established technically. BALF was proved to be a good diagnostic probe for rejection monitoring in primate.