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

1.保存：结果表明，具有缓冲作用的细胞外液成分和温度是影响保存效果的重要因素。吸入一氧化氮可改善移植物的功能。2.再植入反应：乌司他丁、g-羟基丁酸酯、硫氧还蛋白、α-受体阻滞剂对移植后肺水肿有保护作用，提示再灌注损伤和去自主神经参与了这一过程。3.排斥反应和免疫抑制：供者皮肤成纤维细胞毒性试验是检测犬肺移植急性排斥反应的有效方法，其细胞毒性指数与移植肺内单个核细胞浸润程度有关。肺移植排斥反应的监测 ...更多信息 此外，一氧化氮气体浓度的测定可能是有用的，因为其浓度的增加与排斥反应的病理分级相关。4.供体来源的扩大：在灵长类动物序贯双侧肺移植模型中，证明了脑死亡、无心跳供体的肺移植是可能的。无心跳供体肺移植将扩大供体标准的适应证，增加供体来源。在异种心脏移植领域，应用抗T细胞受体抗体在小鼠和大鼠之间建立了协调性心脏移植模型，证明了诱导移植耐受的可能性。5.移植标准：对14例弥漫性肺部疾病患者从吸氧开始到死亡的时间进行了评估，以确定移植的合适时间点。尽管需要进一步的（200）经验，但假设氧气补充的起始点适用于登记，因为大多数病例在该点后3年内死亡。少

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