| Budget Amount *help |
¥2,200,000 (Direct Cost: ¥2,200,000)
Fiscal Year 1997: ¥400,000 (Direct Cost: ¥400,000)
Fiscal Year 1996: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 1995: ¥1,300,000 (Direct Cost: ¥1,300,000)
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| Research Abstract |
The standard clinical protocol for lung transplantation employs cold single pulmonary artery flush with Euro-Collins solution (ECS) or the University of Wisconsin solution (UWS). Prostaglandin El (PGE1) is usually given by direct injection into the pulmonary artery to reduce pulmonary vasoconstriction caused by high-potassium condition, however, the efficacy of PGE1 on lung preservation remains controversial. In the first experimental study using an isolated perfused rat lung model, we demonstrated that vasodilatory effects of PGE1 were markedly reduced under a high-potassium condition, and that potassium-induced pulmonary vasoconstriction were inhibited by calcium channel blocker nifedipine (Shigeyuki Sasaki, Keishu Yasuda, et al. Does PGE1 attenuate potassium-induced vasoconstriction in initial pulmonary artery flush on lung preservation? Submitted to The Journal of Heart and Lung Transplantation). Based on these results, we carried out the transplantation study using a rat lung tran
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splant model which we have previously developed. The excised rat lungs (n=30) were flushed with either UWS with a prior injection of 50 mug/kg PGE1 into the pulmonary artery (UWS+PGE1 ; n=7) , UWS only (UWS ; n=7) , or UWS containing nifedipine (UWS+Nif ; n=8). After cold storage for 24 hours, all lungs were reperfused for 2 hours using an isolated, pulsatile blood perfused lung model. Control lungs (n=8) were reperfused immediately after harvest. Blood gas analysis and shunt fraction, lung airway resistance, dynamic lung compliance, and pulmonary vascular resistance were assessed. The pO2 in UWS and UWS+PGE1 group during the perfusion period were significantly deteriorated than those in UWS+Nif group. Shunt fraction, lung airway resistance, and dynamic lung complaince also demonstrated the superiority of UWS+Nif group. In conclusion, the early graft function after storage was significantly enhanced in lungs flushed with UWS containing nifedipine. Calcium channel blocker is more effective than PGE1 in reducing the potassium-induced vasoconstriction. Pretreatment with PGE1 prior to lung harvest in the current program should be replaced with the use of calcium hannel blocker (Shigeyuki Sasaki, Keishu Yasuda, et al.Calcium Channel Blocker Enhances Lung Preservation. Submitted to The Journal of Heart and Lung Transplantation). Less
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