2000 Fiscal Year Final Research Report Summary
Bronchial brushing as an early diagnostic method for lung allograft rejection in primate lung transplant mo
| Project/Area Number |
10470269
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| Research Category |
Grant-in-Aid for Scientific Research (B).
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Thoracic surgery
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| Research Institution | Tohoku University |
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Principal Investigator |
MATSUMURA Yuji Tohoku Univ. Hospital, Lecturer., 医学部・附属病院, 助手 (80281997)
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| Co-Investigator(Kenkyū-buntansha) |
KONDO Takashi Tohoku Univ. Institute of Development, Aging and Cancer, Professor, 加齢医学研究所, 教授 (10195901)
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| Project Period (FY) |
1998 – 2000
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| Keywords | lung transplantation / allograft rejection / bronchofiberscope / Bronchial mucosal blood flow |
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| Research Abstract |
Although TBLB is a useful and gold standard method for the detection of pulmonary allograft rejection (AR), there is no reliable and less invasive diagnostic method of AR in the acute phase after lung transplantation (Tx). We tried bronchial brushing as a new diagnostic method for AR in primate lung transplant model. Although this mothod is less invasive than TBLB.necrosis and inflammation of bronchial tree couased by reperfusion injury influence the results of bronchial brushing. There are some difficulties to apply this method in the acute phase. Bronchial mucosal blood flow (BMBF) was reported as a useful diagnostic method of AR in animal experiments previously. BMBF reductions correlated with progression of AR.We measured BMBF in three patients after single lung Tx. BMBF measurements were done with a laser-doppler flow meter (ALF21, Advance, Tokyo, Japan). Two points of donor lung : 2nd carina, B6/ basal bronchus. Two points of recipient lung : 2nd carina, B6/basal bronchus, and the tracheal carina as a control were selected as the points of measurement. Assessments were done with mean BMBF of each points and ratios of each points to value of the tracheal carina (BMBF index). BMBF measurements were done without any complication. BMBF at the tracheal carina did not decrease after single lung Tx and BMBF index will be useful as a reliable indicator of BMBF.Mean BMBF value under 20ml/min/100g at the donor 2nd carina, or the donor 2nd carina/tracheal carina ratio under 0.4 will be an indicator of acute rejection during first week after Tx. BMBF measurement will be useful for detecting AR after clinical lung Tx. Futher clinical study will be necessary to apply BMBF as a diagnostic method of AR for bilateral lung Tx or living lobar lung
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