OBJECTIVETo explore the impact of different warm ischemia time on structure and function of the non-heart-beating donor lung and to find out the feasibility of non-heart-beating donor in rat lung transplantation.

METHODSSixty Sprague-Dawley rats were randomly divided into 3 groups: heart-beating donor (HBD) group, non-heart-beating donor (NHBD) with 30 minutes of warm ischemia time (WIT) group and NHBD with 60 minutes of WIT group. Each group has 10 pairs (the donors and the recipients). The donor lungs of group HBD were flushed with low potassium dextran (LPD) solution at 4 degrees C after asystolia while the lungs of group NHBD-30 and group NHBD-60 remained ventilated at the room temperature for 30 and 60 minutes after asystolia and then were flushed with LPD solution. All the donor lungs remained inflated when they were stored in LPD solution at 4 degrees C for 4 hours. The recipient rat underwent left thoracotomy, and then orthotopic left lung transplantation. Followed by a right thoracotomy, the right pulmonary hilum were ligated with one-hour reperfusion and ventilation.

RESULTSAll the recipients in group HBD and group NHBD-30 survived the observation period of one hour with excellent gas exchange, whereas 4 of recipients in group NHBD-60 survived for 10 minutes after the ligation of right pulmonary hilum and 3 for 20 minutes. The pulmonary compliance, ultrastructure, energy metabolite and other markers revealed no significant differences between group HBD and group NHBD-30 (P > 0.05). But the differences between group NHBD-60 and other two groups were significant (P < 0.05).

CONCLUSIONSThe adoption of non-heart-beating donor could be a safe and effective method to expand the lung donor pool. The NHBD lung with 30 minutes of WIT may be suitable for lung transplantation in rat.

Animals ; Heart ; physiopathology ; Ischemia ; physiopathology ; Lung ; physiopathology ; ultrastructure ; Lung Transplantation ; Male ; Microscopy, Electron ; Models, Animal ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Time Factors ; Tissue Donors

OBJECTIVETo study the effect of tetramethylpyrazine (TMP) on the vascular endothelial cell (VEC) related humoral factors, including endothelin (ET), factor VIII related antigen (i.e. von Willebrand factor, vWF) and thromboxane A2(TXA2) in patients of congenital heart disease with pulmonary hypertension (CHD-PH) during cardiopulmonary bypass (CPB), and explore the clinical physiopathologic significance of them.

METHODSThirty non-cyanotic patients of CHD-PH were randomly divided into the control group and the treated group. TMP was given to the treated group by intravenous dripping 3 mg/kg after anesthesia induction and adding 1 mg/kg in oxygenator during CPB. Blood samples were collected from radial artery at the time points of after anesthesia induction, 15 min after beginning CPB, 5 min after opening aorta, 20 min, 6 hrs and 24 hrs after stopping CPB, to determine the plasma contents of ET and vWF, as well as TXB2, the stable metabolite of TXA2. The pulmonary vascular reactivity 6 hrs (6h-PVR) after CPB and the mechanical ventilatory support time (VST) after operation were calculated.

RESULTSLevels of ET, vWF and TXB2 increased obviously during CPB, but the degree of increasing in the treated group was lower than that in the control group (P < 0.05), and the 6h-PVR and VST in the former were also lower than those in the latter respectively.

CONCLUSIONTMP could obviously reduce the production of ET, vWF and TXB2 during CPB and relieve the pulmonary vascular reactivity after operation, indicating that TMP could reduce the injury of CPB on VEC, and is benefit to enhance the efficacy of treatment.

Adolescent ; Adult ; Calcium Channel Blockers ; therapeutic use ; Cardiopulmonary Bypass ; Child ; Child, Preschool ; Endothelins ; blood ; Female ; Heart Defects, Congenital ; physiopathology ; surgery ; Humans ; Hypertension, Pulmonary ; drug therapy ; physiopathology ; Male ; Pyrazines ; therapeutic use ; Thromboxane B2 ; blood ; von Willebrand Factor ; metabolism