MULTI-CENTER STUDIES FOR CLINICAL APPLICATION OF PEDIATRIC HEART AND LUNG TRANSPLANTATION IN JAPAN

在3年的计划中，15名研究人员对以下主题进行了研究：关于小儿心脏和/或肺移植的手术技术和保存，类固醇在肺保存中对水运输活动的有益影响(Fujimura)，超氧化物合成抑制剂OPC-6535对儿童心脏再灌注损伤的有益效果(Yasui)，尼可地尔对窒息停跳心脏复苏的有益效果(SANO)，混合人工血管在肺移植中的应用(WADA)，并对活体叶肺移植(Miyoshi，Miyoshi)的手术方法和术后护理进行了研究，对日本儿科心脏病学会(Okada，Echigo，Kato)的儿科心脏病专家或心脏外科医生在全国范围内对扩张型心肌病、先天性心脏病伴充血性心力衰竭和原发性肺动脉高压的预后进行了评估。评价心肺联合移植或肺移植联合心脏修补术治疗先天性心脏病(Matsuda)的适应证，评估原发性肺动脉高压(Momma)的预后。评价静脉注射前列环素治疗原发性肺动脉高压(SAJI)的疗效。对接受心脏和/或肺移植的儿童患者的结果进行评估(小林)。根据儿童脑死亡的确定，评估几个中心的脑死亡儿童的结果(Mitsuome)和九州儿童脑死亡的诊断(松下)。最后，评估针对猪的预制抗体在日本幼猴超急性排斥或迟发性异种移植排斥反应中的作用，以扩大儿童器官移植的供者池(川口)。

During 3 years of the program, 15 investigators have studied each theme shown below.Regards to operative technique and preservation of pediatric heart and/or lung transplantation, the beneficial effects of steroid on water transport activity in lung preservation (Fujimura), the beneficial effects of superoxide synthesis inhibitor, OPC-6535 on reperfusion injury of pediatric hearts (Yasui), the beneficial effects of nicorandil on reanimation of asphyxiatedly arrest hearts (Sano), application of hybrid artificial vessels for pulmonary artery reconstruction in lung transplantation (Wada), and studies of operative technique and post-operative care of living-donor lobar lung transplantation (Miyoshi) were done.Regards to indications for pediatric heart and/or lung transplantation, prognosis of dilated cardiomyopathy, congenital heart disease with congestive heart failure, and primary pulmonary hypertension were evaluated using nation-wide questionnaire to pediatric cardiologists or cardiac surgeons who belong to the Society for Japanese Pediatric Cardiology (Okada, Echigo, Kato). Indication of heart/lung transplantation or lung transplantation with combined cardiac repair was evaluated in congenital heart disease (Matsuda), Prognosis of primary pulmonary hypertension was evaluated (Momma). The effects of Intravenous administration of prostacyclin for primary pulmonary hypertension was evaluated (Saji). The outcomes of pediatric patients who underwent heart and/or lung transplantation was evaluated (Kobayashi).Regards to determination of brain death in children, outcomes of brain dead children in several centers were evaluated (Mitsudome) and diagnosis of brain death in children in Kyoshu was evaluated (Matsuishi).Finally, the role of preformed antibody against pigs in hyperacute rejection or delayed xenograft rejection was evaluated in infant Japanese monkey to expand donor pool for pediatric organ transplantation (Kawauchi).