Grant-in-Aid for Scientific Research (B).
|Research Institution||Tokyo Women's medical college|
KOYANAGI Hitoshi Tokyo Women's Medical College. Dept. of Cardiovascular Surgery. Professor., 医学部, 教授 (90138884)
KITAMURA Masaya Tokyo Women's Meddical College. Dept. of Cardiovascular Surgery. Assistant., 医学部, 助手 (90183300)
HACHIDA Mitsuhiro Tokyo Women's Meddical College. Dept. of Cardiovascular Surgery. Assistant., 医学部, 助手 (00167587)
榊原 尚豪 東京女子医科大学, 循環器外科学, 助手 (70119957)
ENDO Masahiro Tokyo Women's Meddical College. Dept. of Cardiovascular Surgery. Professor., 医学部, 教授 (20075302)
HASHIMOTO Akimasa Tokyo Women's Meddical College. Dept. of Cardiovascular Surgery. Professor., 医学部, 教授 (90075185)
平田 欽也 東京女子医科大学, 医学部, 助手
NONOYAMA Masaki Tokyo Women's Meddical College. Dept. of Cardiovascular Surgery. Assistant., 医学部, 助手 (40201701)
江石 清行 東京女子医科大学, 医学部, 助手 (20167290)
|Project Fiscal Year
1989 – 1991
Completed(Fiscal Year 1991)
|Budget Amount *help
¥6,400,000 (Direct Cost : ¥6,400,000)
Fiscal Year 1991 : ¥800,000 (Direct Cost : ¥800,000)
Fiscal Year 1990 : ¥700,000 (Direct Cost : ¥700,000)
Fiscal Year 1989 : ¥4,900,000 (Direct Cost : ¥4,900,000)
|Keywords||Heart Transplantation / Rejection / Electrophysiologic Study / refractory Period / 心臓移植 / 心肺移植 / 拒絶反応 / 免疫抑制剤 / 食道ペ-シング / 電気生理学的方法 / 心筋拒絶反応 / 肺再潅流障害 / 免疫抑制療法 / 多臓器保存法 / UCLA溶液 / 急性拒絶反応 / 電気生理学的検査 / 病理組織学的検査 / 刺激伝導系|
Electrophysiologic and Histopathologic Evaluation of the Transplanted Heart
MATERIALS AND METHODS
Lewis (LEW/Crj) were donors of isografts or Lewis (LEW/Crj ; n=6) or Wistar King (WKAH/HKm ; n=12) recipients. Intra-abdominal heart transplantation (Tx) was performed by the method of Ono and Lindsey in adult male inbred rats (250 to 300g).
The hook-tipped bipolar endocardial leads were set up in the right atrial and right ventricular walls. ERP-AVCS was asseeed by programed extrastimulus method (basic cycle length of 150 msec) in early (2nd day), medium (7-9th day) and late (11-14th day) post-Tx periods.
Specimens of the conduction system and vetricular septum were examined liistopathologically at the end of final ERP study. A control group of isogenic Tx (between LEW/Crj rats : n=6) had no immunosuppressant. The allogenic Tx group (LEW/Cri WKAH/HK m ; n=12) was treated with cyclosporine (lOmg/kg/day) until sacrificed and six rats of this group were given prednisolone (I. 0 mg/kg/day) orally
on the second postoperative week.
Control group showed no change in both ERP-AVCS and histopathologic findings. Individual values of ERP-AVCS obtained in days seven to nine were elevated 20% or higher than those of day two in all cases of allogenic Tx group. This change was statistically significant ; mean <plus-minus> SD were 84 <plus-minus> 6 msec on day two to 108 <plus-minus> 10 msec on day 7-9(p<0.0 1). Of these, six hearts were examined after medium ERP study, showing mononuclear cell infiltration without myocyte necrosis especially in the conduction system. ERP-AVCS of the remaining six rats on day 11-14 was recovered to initial values obtained on day two within 10% range. Their specimens showed less predominant cell infiltration. Tlie ERP-AVCSs of one allograft (Oo. 9) are represented. The ERP-AVCSof this heart was prolonged from 84 msec on post-Tx day two to 114 msec on day 7 and recovered to 88 msec on postoperative d
These results suggest that the prolongation of ERP-AVCS could be a useful paramenter for diagnosing mild acute rejection in the prenecrotic stage under immunosuppressive treatment following heart transplantation. This offers that the electrophysiologic monitoring may be suitable for use during the first four to six weeks after heart transplantation, while the appropriate epicardial transcutaneous electrodes are in place. Less