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

在3年的计划中，15名研究人员研究了以下主题：关于小儿心脏和/或肺移植的手术技术和保存，类固醇对肺保存中水转运活性的有益作用（Fujimura），超氧化物合成抑制剂OPC-6535对小儿心脏再灌注损伤的有益作用（Yasui），尼可地尔对窒息性心脏骤停复苏的有益作用（佐野），混合人工血管在肺移植肺动脉重建中的应用（Wada），活体肺叶移植术的手术技巧和术后护理的研究关于小儿心脏和/或肺移植的适应症，使用全国范围的调查问卷对属于日本小儿心脏病学会的小儿心脏病专家或心脏外科医生评估扩张型心肌病、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（冈田越后加藤）。评价先天性心脏病（Matsuda）心/肺移植或肺移植联合心脏修补术的适应证，评价原发性肺动脉高压（Momma）的预后。评价了前列环素静脉给药对原发性肺动脉高压的影响（Saji）。评估了接受心脏和/或肺移植的儿科患者的结局（小林）关于儿童脑死亡的确定，对几个中心的脑死亡儿童的结果进行了评价（Mitsudome）和诊断脑死亡的儿童在京州进行了评价最后，在幼年日本猴中评价了针对猪预先形成的抗体在超急性排斥或延迟性异种移植排斥中的作用，以扩大用于儿科的供体库器官移植（川内）。

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).