transplantologiyaТрансплантологияTransplantologiya. The Russian Journal of Transplantation2074-05062542-0909IPO Association of Transplantologiststransplantologiya-21Research ArticleПРОБЛЕМНЫЕ АСПЕКТЫPROBLEMATIC ASPECTSВлияние ингибиторов фосфодиэстеразы-5 на альвеолярный кровоток легочного трансплантатаThe effect of phosphodiesterase-5 inhibitors on the alveolar blood fl ow in the pulmonary graftЯблонскийП. К.YablonskiyP. K.РезникО. Н.ReznikO. N.СкворцовА. Е.SkvortsovA. E.skvortsov.spb@gmail.comМилехинВ. Е.MilehinV. E.ФГБУ «Санкт-Петербургский НИИ фтизиопульмонологии» Министерства здравоохранения РФ, Санкт-ПетербургРоссияFSBI «St. Petersburg Research Institute of Phthisiopulmonology» Ministry of Health of the Russian Federation, St. PetersburgRussian FederationГБОУ «Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова» Министерства здравоохранения РФ, Санкт-ПетербургРоссияSEI «The First St. Petersburg State Medical University named after I.P. Pavlov» Ministry of Health of the Russian Federation, St. PetersburgRussian FederationФГБУ «Санкт-Петербургский НИИ фтизиопульмонологии» Министерства здравоохранения РФ, Санкт-Петербург,РоссияFSBI «St. Petersburg Research Institute of Phthisiopulmonology» Ministry of Health of the Russian Federation, St. Petersburg,Russian Federation20132701201603Трансплантология2833Copyright © Яблонский П.К., Резник О.Н., Скворцов А.Е., Милехин В.Е., 20162016Яблонский П.К., Резник О.Н., Скворцов А.Е., Милехин В.Е.Yablonskiy P.K., Reznik O.N., Skvortsov A.E., Milehin V.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jtransplantologiya.ru/jour/article/view/21 

 

Трансплантация легких – эффективный радикальный хирургический способ лечения хронических заболеваний легких в терминальной стадии. Применение препаратов, оказывающих вазоплегическое действие на гладкую мускулатуру сосудистого русла малого круга кровообращения, до начала консервации и оценка функционального состояния икроциркуляторного русла органа в постреперфузионном периоде могут позволить улучшить клинические результаты таких операций и увеличить сроки функционирования легочного трансплантата в организме реципиента.

Использованы 54 животных (немецкая полевая свинья массой тела 32,3±0,6 кг, мужского пола), из них 42 (доноры и реципиенты) были разделены на три группы в зависимости от способа консервации. Для оценки параметров микроциркуляции применяли ортогонально поляризованную спектральную видеомикроскопию (ОСВМ).

При введении в легочный ствол ингибитора фосфодиэстеразы-5 (ФДЭ-5) за 20 мин до начала консервации выявлено достоверное увеличение суммарной длины открытых капилляров на одно альвеолярное поле (486,3±258,1 к исходному 240,8±127,9 мкм; р<0,001) и индекса капиллярного кровотока альвеол – ИКК (515,0 к исходному 249,2 мкм/мкм2; р<0,001), а также среднего диаметра альвеол – сДА (91,2±52,3 к исходному 85,1±41,5 мкм; р<0,05).

Применение ингибитора ФДЭ-5 за 20 мин до начала перфузии легочного трансплантата консервирующим раствором улучшает оксигенирующую способность трансплантированного легкого. ОСВМ является достоверным методом оценки и мониторинга параметров микроциркуляции легочной ткани in vivo.

 

 

Lung transplantation – an effective way to radical surgical treatment of chronic lung disease in the terminal stage. The use of drugs with extending effect on vascular smooth musculature of the pulmonary circulatory system, prior to conservation and assessment of the functional state of the microvasculature in the postreperfusion period may result in improved clinical outcomes of such operations and increase the duration of the functioning of the lung transplant in the body of the recipient.

Fifty four animals were used (German Field Pig, 32,3±0,6 kg, male). Forty two animals (donors and recipients) were divided into three groups according to the method of conservation. Orthogonally polarized spectral video microscopy (OPSVM) was applied for estimation the parameters of microcirculation.

Injection of a phosphodiesterase-5 (PDE-5) inhibitor into the pulmonary trunk at 20 min before conservation significantly increases the total length of open alveolar capillaries per field (486,3±258,1 mkm in comparison to the initial 240,8±127,9 mkm; p<0,001) and the index of capillary blood flow of the alveoli (515,0 in comparison to the initial 249,2 mkm/mkm2; p<0,001), also the increase of the mean diameter of the alveoli was found (91,2±52,3 mkm in comparison to the initial 85,1±41,5 mkm; p<0,05).

The use of PDE-5 inhibitor at 20 min before the start of perfusion of lung transplant with conservation solution improves the oxygenizing ability of the transplanted lung. OPSVM is a reliable method for assessing and monitoring the parameters of microcirculation of lung tissue in vivo.

 

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The authors declare that there are no conflicts of interest present.