肺移植体外肺灌注心死亡猪动物模型的构建  

Establishment of the pig lung transplant model with Ex vivo lung perfusion from the donation after cardiac death

作　　者：彭桂林[1] 杨超[1] 崔伟学 梁丽霞[2] 杨汉宇[2] 刘梦杨 王义东[2] 孟凡勇 徐鑫[1] Peng Guilin;Yang Chao;Cui Weixue;Liang Lixia;Yang Hanyu;Liu Mengyang;Wang Yidong;Meng Fanyong;Xu Xin(Department of Organ Transplantation,1st Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China;Department of Anesthesiology,1st Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China)

机构地区：[1]广州医科大学附属第一医院器官移植科,510120 [2]广州医科大学附属第一医院麻醉手术科,510120

出　　处：《中华实验外科杂志》2020年第8期1541-1543,共3页Chinese Journal of Experimental Surgery

基　　金：广东省医学科学技术研究基金(A2019261)。

摘　　要：目的构建肺移植心死亡猪动物模型,揭示体外肺灌注技术在肺损伤修复中的作用。方法将巴马小型猪随机分为供体组和受体组各8只,供体组再随机分为实验组(即体外肺灌注组)和对照组各4只(购自东莞松山湖明珠实验动物科技有限公司)通过气管插管后脱氧的办法诱导缺氧并导致心死亡,实验组供体猪肺获取后经低温保存10 h取出,连接管道并建立体外肺灌注系统,监测氧合指数,气道压力,肺血管阻力,肺顺应性,左房压力等指标了解灌注效果并最终移植到受体猪中,评价体外肺灌注技术对供体肺的修复作用。运用t检验、Kruskal-Wallis检验、χ^2检验完成统计学分析。结果体外肺灌注期间,实验组氧合指数明显升高,1 h及4 h的氧合指数分别为(279.0±17.0)、(442.5±17.5)mmHg(1 mmHg=0.133 kPa,t=15.176,F=0.146,P<0.01);肺血管阻力明显下降,1 h及4 h分别为(571.43±57.14)、(314.29±28.58)dynes/s/cm^5(t=9.258,F=2.455,P<0.01);肺动脉压力明显下降,1 h及4 h分别为(14.0±1.0)、(8.5±0.5)mmHg(t=12.011,F=0.158,P<0.01);气道压力明显下降1 h及4 h分别为(17.0±1.0)、(12.5±0.5)cmH2O(1 cmH2O=0.098 kPa,t=8.878,F=0.158,P<0.01)。移植后实验组氧合指数表现稳定,对照组氧合指数在120 min后出现下降,而且实验组氧合指数基线较对照组高。结论该方法可构建出重复性强的体外肺灌注心死亡猪动物模型。Objective To establish the pig lung transplant model from the donation after cardiac death,and reveal the recovery effect of Ex vivo lung perfusion(EVLP)in lung injury.Methods Sixteen pigs involved in the experiment,8 in experimental group and 8 in control group.Pigs were induced the cardiac death by removing the oxygen after tracheal intubation.At 10 h of 4℃storage after the procurement,the donor lungs were connected to the EVLP system,the oxygenation index,airway pressure,pulmonary vascular resistance,pulmonary compliance and left atrial pressure were detected,and then the donor lungs were transplanted into the recipient pigs.The recovery effect of Ex vivo lung perfusion in donor lung injury was evaluated.The t test,Kruskal-Wallis test and Chi-square test were used to carry out the statistical analysis and SPSS 22 was used to finish the data processing.Results In the EVLP experiment,the oxygenation index increased obviously,which was(279.0±17.0)and(442.5±17.5)mmHg at 1st and 4th h(1 mmHg=0.133 kPa,t=15.176,F=0.146,P<0.01),respectively.The pulmonary vascular resistance decreased obviously,which was(571.43±57.14)dynes/s/cm^5 and(314.29±28.58)dynes/s/cm^5 at 1st and 4th h(t=9.258,F=2.455,P<0.01),respectively.The pressure of pulmonary artery also decrease obviously,which was(14.0±1.0)and(8.5±0.5)mmHg at 1st and 4th h(t=12.011,F=0.158,P<0.01),respectively.The airway pressure also decrease,which was(17.0±1.0)and(12.5±0.5)cmH2O at 1st and 4th h(1 cmH2O=0.098 kPa,t=8.878,F=0.158,P<0.01),respectively.With the high baseline,the oxygenation index was also steady in experimental group compared to the control group,especially after 120 min.Conclusion The method explored above to establish the pig model with EVLP from the donation after cardiac death is feasible and repeatable.

关 键 词：肺移植 体外肺灌注 模型 动物 猪 

分 类 号：R655.3[医药卫生—外科学] R-332[医药卫生—临床医学]