Lung and Heart-Lung Transplantation - Indication, Preservation and Retaining of Long-term Function.

-肺保存-根据先前研究中获得的保存改进结果，我们可以在体外简单冷却条件下安全保存犬肺长达48小时（Nakada）。我们研究了热缺血时间，发现犬肺可耐受的热缺血时间约为120分钟（Hitome）。-肺移植-移植后排斥反应的免疫学监测，选择支气管肺泡灌洗液、胸腺、淋巴结和外周血淋巴细胞标本进行研究。其中，分析支气管肺泡灌洗液中的淋巴细胞被认为是最有用的免疫监测工具之一（Kusakawa, Okada）。另一个早期诊断排斥反应的试验是用激光多普勒法测量支气管吻合口周围的血流（Hitomi, Kusakawa）。这可能是今后监测排斥反应的有效方法之一。同时对移植肺的血流动力学变化进行了研究。这项研究的结果是发现移植肺在其毛细血管床上有足够的储备容量（Koyanagi）。-心肺保存-认为自体灌注法联合亚低温可能是一种有效的心肺保存方法（Matsumoto）。由于自体灌流保存犬心肺6小时，移植后心脏功能相当耐受。但也观察到进行性和严重的肺损伤（Tanabe）。预防这种肺损伤可能是成功的心肺移植最重要的。-心肺移植-一项研究心肺去神经后激素变化的新试验，特别是血液ADH和ANP。本实验揭示了心肺移植（Nadkada）后水分平衡控制的重要性。

-Lung Preservation - According to results of the improvenent of preservation obtained from the previous studies, it becomes feasible for us to preserve canine lung under extracorporeal simple cooling conditions up to 48 hours safely(Nakada). We have investigated the warm ischemic time and have found that the tolerable warm ischemic time was considered to be about 120 min. for canine lung(Hitome).-Lung Transplantation - As to the immunological monitoring of rejection after transplantation, lymphocyte samples from bronchoalveolar lavage fluid, thymus,lymphnodes and peripheral blood were chosen to investigate. Among them, analysis of lymphcytes in bronchoalveolar lavage fluid was considered to be one of the most useful tools for immunological monitoring(Kusakawa, Okada). Another trials for early diagnosis of rejection were to measure the blood flow around the bronchial anastomosis by LASER-Doppler method(Hitomi, Kusakawa). This may be one of the effective methods for monitoring rejection in the future. Study on the hemodynamic change of transplanted lung was also performed. In consequence of this study, transplanted lung was found to have enough reserved capacity on its capillary beds(Koyanagi).- Heart-Lung Preservation - It was considered that the autoperfusion method combined mild hypothermia might be useful method for heart-lung preservation(Matsumoto). As a result of 6-hour canine heart-lung preservation using autoperfusion, cardiac function was fairly tolerated after transplantation. But progressive and severe lung damage was also observed(Tanabe). Prevetion of this lung damage may be the most important for successful heart-lung transplantation.- Heart-Lung Transplantation - A new trial to investigate hormonal change after cardiopulmonary denervation especially blood ADH and ANP was performed. This experiment disclosed the importance of control of the water balance after heart-lung transplantation(Nadkada).