雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Kokyu to Junkan Volume 46, Issue 7 （July 1998）

呼吸と循環 46巻7号（1998年7月発行）

Japanese English

研究

原発性肺高血圧症に対する生体部分肺移植後の呼吸機能検査の評価 Respiratory Function after Living Donor Lobar Lung Transplantation for Primary Pulmonary Hypertension:A case report 平山佳代子 ¹ , 中山智孝 ¹ , 佐地勉 ¹ , 小澤安文 ¹ , 星田宏 ¹ , 鶴田恵子 ¹ , 松裏裕行 ¹ , 松尾準雄 ¹ , 加藤信秀 ² , 高木啓吾 ² , 山崎史朗 ² Kayoko Hirayama ¹ , Tomotaka Nakayama ¹ , Tsutomu Saji ¹ , Yasufumi Ozawa ¹ , Hiroshi Hosida ¹ , Keiko Tsuruta ¹ , Hiroyuki Matsuura ¹ , Norio Matsuo ¹ , Nobuhide Kato ² , Keigo Takagi ² , Siro Yamazaki ² ¹東邦大学医学部第一小児科 ²東邦大学胸部心臓血管外科 ¹The First Department of Pediatrics, Toho University School of Medicine ²The Department of Cardiothoracic Surgery, Toho University School of Medicine キーワード：原発性肺高血圧症 , 生体部分肺移植 , 呼吸機能検査 , primary pulmonary hypertension , living related lung lobar transplantation , pulmonary function test Keyword: 原発性肺高血圧症 , 生体部分肺移植 , 呼吸機能検査 , primary pulmonary hypertension , living related lung lobar transplantation , pulmonary function test pp.705-710

発行日 1998年7月15日 Published Date 1998/7/15

DOI https://doi.org/10.11477/mf.1404901730

PDF(10155KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside

　今回われわれは，提供者を両親とした生体部分肺移植症例を経験した．対象は11歳の原発性肺高血圧症の女児で，父の右下葉および母の左下葉がそれぞれ患児の右左肺として移植された．術後3カ月目の心臓カテーテル検査では，術前と比べ平均肺動脈圧は60から20mmHgへ，全肺血管抵抗値は15単位から2単位へと改善がみられた．移植肺の呼吸機能検査（PFT）では，％VCは術後2カ月以降は80％以上を維持し，閉塞性細気管支炎の指標となるFEV1.0％も常に80％以上と安定していた．また，DLco／VAも平均4.11ml／min／mmHg／lで変動なく経過していた．本症例では呼吸器感染症や拒絶反応はみられず，またPFTの結果から，拘束性および閉塞性換気障害ともに認められず，循環動態に加え呼吸機能に関しても良好に保たれていると考えられた．

We evaluated the pulmonary function tests (PFT) in an 11-year-old girl who underwent living donor lobar lung transplantation for primary pulmonary hyperten-sion, performed in Childrens Hospital Los Angeles (CHLA). The donors were her parents. After both lungs of the patient were removed, her father's right lower lobe and her mother's left lower lobe were resected and transplanted to her right and left lung, respectively.

We examined cardiac catheterization at 3 month and PFT monthly after transplantation. The mean pulmo-nary artery pressure (from 60mmHg to 20mmHg) and pulmonary vascular resistance (from 15 Wood units to 2 Wood units) had significantly decreased.

% VC decreased to 63 % at 1 month after transplanta-tion, but returned to more than 80 % 2 months later and has continued at normal range. FEV_1.0%, as a clinical indicator of the obstructive bronchiolitis syndrome, has also continued at a level of more than 80 %.

RV/TLC increased to 0.35 at 3 months.

We considered that the transplanted lung was slightly over inflated lung, but PFT improved. DLco/VA has also been stabilized.

Obstructive or restrictive ventilatory disturbance was not found 1 year after surgery.

We conclude that the transplanted lobes from her parents seem to be normal in respiratory function and that the hemodynamics after the transplant operation are also normal.