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

确定肺和心肺移植中移植物的临床适应症和安全管理方法的研究项目。

基本信息

批准号：
06304036
负责人：
FUJIMURA Shigefumi
金额：
$ 19.26万
依托单位：
Tohoku University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (A)
财政年份：
1994
资助国家：
日本
起止时间：
1994 至 1996
项目状态：
已结题

项目摘要

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

1.保存：研究表明，具有保存液缓冲作用的细胞外成分和温度都是保存中非常重要的因素。事实证明，吸入一氧化氮可以改善保存的移植物的功能。为了评估保留移植物的功能，测量滤过系数或肺泡液清除率可能有用。2.再植入反应：尿司他丁、g-羟丁酯、硫氧还蛋白、α-受体阻滞剂被发现对移植后肺水肿有保护作用，表明不仅再灌注损伤，自主神经去神经也参与了这种情况。 3.排斥反应和免疫抑制：供体皮肤成纤维细胞的细胞毒性试验是检测犬肺移植中(100)急性排斥反应的有效方法，同种异体肺移植物中单核细胞浸润的程度与细胞毒性指数的值相关。为了监测肺移植中的排斥反应，测量一氧化氮浓度可能是有用的，因为一氧化氮浓度的增加与排斥反应的病理分级相关。4.扩大供体来源：在灵长类序贯双侧肺移植模型中，来自脑死亡、无心跳供体的肺移植被证明是可能的。无心跳供体肺移植将扩大供体标准的适应症，导致供体来源的增加。在异种移植领域，通过给予抗T细胞受体抗体，显示了在小鼠和大鼠之间诱导一致心脏移植模型耐受的可能性。 5.受者标准：为了确定移植的适当时间点，对14例弥漫性肺部疾病患者从吸氧起始点到死亡的期限进行了评估。尽管需要进一步的（200）经验，但假设补充氧气的起始点适合登记，因为大多数病例在该点起的 3 年内死亡。较少的