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肺移植 및 肺門部剝離術이 肺機能에 미치는 影響에 關한 實驗的 硏究

Functional Evaluation of the Lung of Domotransplantation and Ifilar Division in Dog

부산의대잡지 1969년 9권 1호 p.33 ~ 56
문남출,
소속 상세정보
문남출 (  ) - 부산대학교 의과대학 흉곽외과

Abstract


Although several series of successful lung auto- and homotransplantations have been reported in the literature during recent years, relatively little progress has been achieved in the problems of derangement of pulmonary function following homotransplantation of lung. The primary object of this study was to critically evaluate the ability of denervated lung and homotransplanted lung to function and sustain life.
Author studied the function of denervated lung by hilar division followed by ligature of contralateral pulmonary artery in 11 dogs, and compared that of the homotransplanted lung in 7 dogs that survived beyond 3 days after homotransplantation of lung.
The lung function studies were carried out with bronchospirometric analysis, blood gas analysis and determination of pulmonary arterial pressure.
The results were as follows.
1. Following homotransplantation of left lung, the initial reduction in respiratory efficiency of this lung was significant and reflected in a greater reduction in oxygen uptake fl-kin in ventilation, but 10 days after operation it showed gradual improvement and the minute ventilation and oxygen uptake were 37.0% and 39.0% respectively.
2. The CO2 output of the homotransplanted lung decreased parellelly with that of oxygen uptake, and consequently the respiratory quotient of homotransplanted lung was constantly within normal limits.
3. Following homotransplantion of lung, the blood oxygenation was significantly impaired even the respiratory function showed ventilation to be improved.
4. Respiratory function studies in 11 dogs of hilar division of left lung showed significant impairment of minute ventilation, oxygen uptake and blood oxygenation, but on the 10th day postoperatively the values were increased nearly normal except blood oxygenation.
5. in the group of hilar division, the oxygen saturation of arterial blood was substantially impaired
throughout the postoperative period until two months after operation.
6. After ligature of the right pulmonary artery two months after left hilar division, all animals sho-
wed immediate elevation of pulmonary arterial pressure and 5 of the 9 dogs died within 30 hours
from acute lung edema,
7. In the 3 dogs that survived for 2 months following ligature of right pulmonary artery, the respiratory efficiency of denervated left lung was well compensated except the blood oxygenation and two months later, contralateral right pneumonectomy was well tolerated. This implies the functional recovery of the denervated lung.

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