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Research Project on the Clinical Indication in Japan and the Posttransplant Patient Management in Lung and Heart-Lung Transplantation.

日本肺和心肺移植的临床适应症和移植后患者管理研究项目。

基本信息

批准号：
09357013
负责人：
FUJIMURA Shigefumi
金额：
$ 17.02万
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：
1997
资助国家：
日本
起止时间：
1997 至 1999
项目状态：
已结题

项目摘要

(1) Clinical indication<Chronic pulmonary emphysema> Incidence of the juvenile type emphysema for lung transplantation in our country was found to be 1 to 2% of all, and the benefit of volume reduction surgery as a bridge therapy has been established.<Primary pulmonary hypertension> Effectiveness of the prostacyclin treatment has been established to date, however, some patients were found to be resistant to this treatment.<Others> Potential candidates for lung transplantation were most frequently found in patients with idiopathic pulmonary fibrosis among several disease entity (idiopathic pulmonary fibrosis, pulmonary lymphoangiomyomatosis, bronchilitis obliterans, pulmonary emphysema).(2) Basic research1) Expansion of the donor poolPossibility of lung transplantation from non-heart-beating donor was demonstrated, and the research on the size matching in living-related lobar transplantation has been started.2) ZenotransplantationFetal lung as a low antigen-presenting model was challenged for zenograft and its usefulness was suggested. Researches on the mechanisms of immune reaction in zenotransplantation has been progressed.3) Posttransplant patient managementPlatelet was found to be contributory in reimplantation response. Triptolide, a kind of Chinese medicine, was found to be a potent immunosuppressive agent. Molecular biological technique (gene transfection) has been strated to be applied for immunosuppression in both acute and chronic rejection in lung transplantation.

(1)我国<Chronic pulmonary emphysema>肺移植术后青少年型肺气肿的发生率为1 ~ 2%，减容手术作为过渡性治疗的益处已被证实。<Primary pulmonary hypertension>迄今为止，前列环素治疗的有效性已经确定，但是，发现一些患者对这种治疗有耐药性。<Others>在几种疾病实体（特发性肺纤维化、肺淋巴管肌瘤病、闭塞性支气管炎、肺气肿）中，最常在特发性肺纤维化患者中发现肺移植的潜在候选者。(2)基础研究1）供体库的扩大无心跳供体肺移植的可能性已得到证实，活体肺叶移植中尺寸匹配的研究已经开始。2）异种移植胎肺作为一种低抗原提呈模型受到异种移植的挑战，并提出了其有用性。对异种移植免疫反应机制的研究取得了一定进展。3）移植后患者的处理血小板被认为是影响再植反应的重要因素。雷公藤甲素是一种有效的免疫抑制剂。分子生物学技术（基因转染）已被证明可用于肺移植急性和慢性排斥反应的免疫抑制。