一种猪模型的体外肺灌注系统的建立

目的:体外肺灌注技术(Ex vivo lung perfusion, EVLP)对于肺移植的实施意义重大,但成本昂贵。本文采用国产经济材料建立猪模型的EVLP系统,以探索保证系统性能的同时降低移植费用。方法:我们首先依据国产材料配置肺灌注液,并组装管道、连接仪器以建立EVLP系统;之后通过外科手段获得3头家猪的肺脏,并灌注肺灌注液,低温保存6小时;最后我们将肺脏连接到EVLP系统,通过血气分析和肺功能检查来评估肺脏随时间变化的状况。结果:离体并在低温保存6小时的猪肺脏,通过我们建立的相对经济的EVLP系统,可以在2小时内维持良好的氧合功能和肺生理指标:肺动脉压、气道峰压、平台压力、肺动脉氧气分压和二氧化碳分压和左心房的氧气分压和二氧化碳分压都保持稳定,同时肺脏具有正常的颜色和弹性,没有明显水肿和功能损害。结论:我们建立的EVLP系统可以有效地维护离体猪肺的生理功能,且降低了成本,从而为肺移植体外肺灌注技术的优化应用提供了研究基础。

Using Porcine Models to Evaluate an ex vivo Lung Perfusion System

ABSTRACT Objective: Ex vivo lung perfusion (EVLP) is significant for lung transplantation but is costly. In this research, the EVLP system of pig model was established by using domestic economic materials to maintain the efficacy of the system while reducing the cost. Methods: We first configured the lung perfusate and assemble chambers via reasonably priced materials to established the EVLP system. Then we surgically obtained the lungs of three domestic pigs, perfused the lung perfusate, and stored them for 6 hours at low temperature. Finally, the lungs were connected to the EVLP system, and blood gas analysis and lung functional examination were used to assess the physiological function of the lungs over time. Results: By using this relatively low-priced EVLP system, we successfully obtained pig lungs and stored them for 6 hours at low temperature. Within 2 hours, the modified lung perfusion system maintained good oxygenation function and lung physiological indexes. Pulmonary arterial pressure, peak inflation pressure, platform pressure, pulmonary oxygen partial pressure and carbon dioxide partial pressure, and left atrial oxygen partial pressure and carbon dioxide partial pressure were all stable, while the lungs had normal color and elasticity without significant edema and functional damage. Conclusion: The EVLP system we established can effectively acquire and store the physiological functions of the donor pig lungs. Besides such systems could reduce costs greatly. Together, what we done provided research basis for optimizing the ex vivo lung perfusion techniques for the application of lung transplantation.