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

肺和心肺移植——长期功能的适应症、保存和保留。

• 批准号: 60304069
• 负责人: NAKADA Tasuku
• 金额: $ 9.66万
• 依托单位: TOHOKU UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Co-operative Research (A)
• 财政年份: 1985
• 资助国家: 日本
• 起止时间: 1985 至 1987
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-60304069/
• 关键词: Lung Transplantation; Heart-Lung Transplantation; Lung Preservation; Heart-Lung Preservation; 免疫監視

-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).

-肺保存 - 根据先前研究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地保存犬肺长达48小时（Nakada）。我们研究了热缺血时间，发现可耐受的热缺血时间被认为是大约120分钟。犬肺(Hitome)。-肺移植-移植后排斥反应的免疫学监测，选取支气管肺泡灌洗液、胸腺、淋巴结和外周血中的淋巴细胞样本进行研究。其中，支气管肺泡灌洗液中淋巴细胞的分析被认为是免疫监测最有用的工具之一（Kusakawa，Okada）。另一项早期诊断排斥反应的试验是通过激光多普勒法（Hitomi，Kusakawa）测量支气管吻合口周围的血流量。这可能是未来监测排斥反应的有效方法之一。还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，移植肺的毛细血管床上有足够的保留容量（小柳）。 - 心肺保存 - 人们认为自灌注法结合亚低温可能是保存心肺的有用方法（松本）。通过自体灌注对犬心肺进行6小时保存，移植后心脏功能具有相当的耐受性。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心肺移植成功的最重要因素。- 心肺移植 - 进行了一项新试验，研究心肺去神经支配后荷尔蒙的变化，尤其是血液 ADH 和 ANP。该实验揭示了心肺移植（Nadkada）后控制水平衡的重要性。

项目成果

Miyawaki, F. et al.: "Mild Hypothermic Autoperfusion as a Heart-Lung Preservation Technique(Second Report).- Its Evaluation on the Metabolism and Histology-" Jap. J. Transpl.22. 469-477 (1987)

Miyawaki, F.等：“轻度低温自灌注作为心肺保存技术（第二份报告）。-其代谢和组织学评价-”日本。

近藤丘: Tohoku J.exp.Med. 149. 323-328 (1986)

近藤冈：东北 J.exp.Med 149. 323-328 (1986)

藤村重文: J. Thorac. Caroliovasc. Sung.94. 323-330 (1987)

Shigefumi Fujimura：J.Thorac Sung.94（1987）。

宮脇富士夫: 移植. 21. 465-472 (1986)

宫胁富士夫：移植。21. 465-472 (1986)

半田政志: 胸部外科. 40. 174-179 (1987)

半田正史：胸外科。40。174-179（1987）