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CoーOperative Study for Clinical Application of Lung and Heart-Lung Transplantation

肺与心肺移植临床应用的合作研究

基本信息

批准号：
01304043
负责人：
HAYATA Y
金额：
$ 8.32万
依托单位：
Tpkyo Medical College, Faculty of Medicine
依托单位国家：
日本
项目类别：
Grant-in-Aid for Co-operative Research (A)
财政年份：
1989
资助国家：
日本
起止时间：
1989 至 1990
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-01304043/
关键词：
Lung and heart-lung transplantation Lung transplantation in rats, dogs and monkey Reperfusion injury Monitoring of early rejection BALF Immunosuppressive agents Wound healing of bronchial anastomotic site Lung preservation after cardiac arre

项目摘要

In the near future lung or heart-lung transplantation will be performed in Japan.At that time we should certainly prevent failures due to rejection. We have performed basic studies such as an organ preservation, monitoring of early rejection, observation of wound healing of anastomotic site of the bronchi, immunosuppressive treatment etc.Organ can be preserved for 5-6 hours using Euro-Collins solution, but the possibility of prolongation for 12-24 hours by the addition of CA^<++>antagonist and/or antioxydizing agents (SOD, CoQ10). In the case of heart-lung preservation, reperfusion injury sometimes develops.In order to suppress this, the application of compliment-activated agent (FUT-175) and/or perfusion using blood from which leukocytes have been removed seem effective. At present as we cannot obtain donor lung from brain death case, use of lungs after cardiac arrest is considered. According to injection of heparin and predonisolone before cardiac arrest in animals preservation for 24 hours will be possible using lung extracted 2 hours after cardiac arrest. For physiological and immunological study of lung and heart-lung transplantation are being performed in rats. Shortening of operation time and ischemic time and improvement of survival rate were obtained. As monitoring parameters of early rejection there was a relationship between early rejection and total cell number, cell analysis, CD4/CD8 rate of leukocytes in BALF in rat, canine and monkey lung transplantation models.In relation to this, donor-specific cytotoxic activity derived from T lymphocytes was observed. There was similar effects of new immunosuppressive agents (FK506 and DSG) compared to cyclosporin A, To observe wound healing of the anastomotic site of the bronchi endoscopic observation of the lesion using fluorescence and blood flow measurement by laser Doppler Velocity were used. A mannual of lung and heart-lung transplantation was published as a step towards human application.

在不久的将来，肺或心肺移植将在日本进行。那时，我们当然应该防止因排斥反应而失败。我们进行了器官保存、早期排斥反应监测、支气管吻合口伤口愈合观察、免疫抑制剂治疗等基础研究，用Euro-Collins液可将器官保存5-6小时，但加入CA^<++>拮抗剂和/或抗氧化剂（SOD、CoQ_（10））可延长12-24小时。在心肺保存的情况下，有时会发生再灌注损伤，为了抑制这种情况，应用补体活化剂（FUT-175）和/或使用去除白细胞的血液进行灌注似乎是有效的。目前，由于我们无法从脑死亡病例中获得供体肺，因此考虑在心脏骤停后使用肺。根据在动物心脏骤停前注射肝素和泼尼松龙，可以使用心脏骤停后2小时提取的肺保存24小时。为了进行肺和心肺移植的生理学和免疫学研究，正在大鼠中进行。缩短了手术时间和缺血时间，提高了生存率。在大鼠、犬和猴肺移植模型中，早期排斥反应与BALF中白细胞总数、细胞分析、CD_4/CD_8比值有关，并观察到供者特异性T淋巴细胞的细胞毒活性。新的免疫抑制剂（FK 506和DSG）与环孢菌素A相比具有相似的作用。为了观察支气管吻合口的伤口愈合，使用荧光内窥镜观察病变，并使用激光多普勒速度测量血流。发表了肺和心肺移植手册，作为向人类应用迈出的一步。