Research Project to Establish the Clinical Indication and the Way for Safe Management of the Graft in Lung and Heart-Lung Transplantation.

点击翻译按钮获取中文摘要

1.Preservation : It was demonstrated that extracellular composition with buffer action of preservation solution and temperature were both quite important factors in preservation. Nitric oxide inhalation proved to improve the function of preserved graft. To evaluate the function of preserved graft, measurement of filtration coefficient or pulmonary alveolar fluid clearance were likely to be useful.2.Reimplantation response : Urinastatin, g-hydroxybutylate, thioredoxin, a-blocker were found to have protective effects on posttransplantation pulmonry edema, suggesting that not only the reperfusion injury but also the autonomic denervation participated in this phenomenon.3.Rejection and immunosuppression : Cytotoxicity test against donor skin fibroblast were useful method to detect (100) acute rejection in canine lung transplantation, and the extent of the mononuclear cell infiltration in pulmonary allograft correlated to the value of cytotoxicity index. To monitor rejection in lung transpl … More antation, measurement of nitric oxide gas concentration is likely to be useful since the increase in the concentration of that was correlated with the pathological grading of rejection.4.Expansion of the donor source : Lung transplantation from the brain-dead, non-heart-beating donor was demonstrated to be possible in the primate sequential bilateral lung transplantation model. Lung transplantation from non-heart-beating donor will expand the indication of the donor criteria, resulting in the increase of donor source. In the field of xenotransplantation, the possibility to induce the tolerance in concordant heart transplantation model between mouse and rat was shown with the administration of anti-T-cell receptor antibody.5.Recipient criteria : To determine the appropriate point for transplantstion, the term from the starting point of oxygen inhalation to death was evaluated in 14 cases with diffuse pulmonary diseases. Although further (200) experience is necessary, it was postulated that the starting point of oxygen supplement was appropriate for the registration since most cases had died within 3 years from that point. Less