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

-肺保存-根据先前研究获得的改进保存的结果，我们可以在体外简单的冷却条件下安全地保存犬肺(Nakada)。我们对热缺血时间进行了研究，发现可耐受的热缺血时间约为120分钟。用于犬肺(HITOME)-肺移植-为监测移植后排斥反应，我们选择了来自支气管肺泡灌洗液、胸腺、淋巴结和外周血的淋巴细胞样本进行了研究。其中，支气管肺泡灌洗液中淋巴细胞的分析被认为是免疫学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用激光多普勒法(Hitomi，Kusakawa)测量支气管吻合口周围的血流。这可能是未来监测排斥反应的有效方法之一。并对移植肺的血流动力学变化进行研究。因此，移植肺在其毛细血管床上有足够的储备容量(小柳)。-心-肺保存-认为自灌注法结合亚低温可能是一种有用的心-肺保存方法(松本)。犬自体灌流心肺保存6小时后，移植后心功能仍可耐受。但也观察到进行性和严重的肺损伤(Tanabe)。防止这种肺损伤可能是心肺移植成功的最重要因素。-心肺移植-一项新的试验，旨在研究去心肺神经后激素的变化，特别是血液中ADH和ANP的变化。本实验揭示了心肺联合移植(Nadkada)后控制水平衡的重要性。

-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).