백서에서의 후두이식

Abstract

Wister백서를 대상으로 26례의 동종 후두이식을 하였다. 공여 백서의 우측 경동맥을 수혜백서의 좌측 경동맥과 10.0prolene으로 여덟 봉합하고, 공여백서의 좌측 경동맥을 수혜백서의 외경정맥과 꼬이지 않게 10.0prolone으로 여섯 봉합을 실시하고 우측 반회신경도 수혜백서의 좌측 반회신경과 10.0prolene 한봉합을 실시하였고 마지막 2례의 기능적 회복을 보인 경우는 위에 정맥이식(vein graft)도 같이 실시하였다. 술후 수시간이내 두마리가 죽고 4례는 술후 2주이내 죽었으며, 나머지 20례중 3개월까지 추적 가능하였던 13례중 7례는 공여 후두가 소실 되었고 3례는 심한 근육위축을 보였으며 1례는 외견상 정상이었으나 기능을 보이지 않았으며 마지막 2례에서 기능적 회복을 보였다. 본 연구의 백서에서 기능적회복은 인간에서의 후두이식을 대비하여 기초가 될 것이다.

Differing from other organs, the success of vascular reanastomosis and funtional reinnervation including voice are important to laryngeal transplantation. 26 cases of the Wister rat (250-300gm) were performed. The donor's right common carotid and recipient's left common carotid artery were connected by 8 stitches 10.0 prolene. The donor's left common carotid artery and recipient's left external jugular vein were connected by 6 stitches 10.0 prolene. The recurrent laryngeal nerves were connected by 1 stitch 10.0 prolene. The last two cases which showed reinnervation were connected by 1 stitch with vein graft.

The results were as follows;

1) 2cases died within 2 hours.

2) 4 cases died within 2 weeks.

3) 13 cases which can be followed for 3 monthes.

7 cases lost donor larynx.

3 cases showed severe muscular atrophy.

1 case showed intact external appearance, but did not reinnervated.

The last 2 cases showed spontaneous movement and reinnervation was identified through glycogen depletion and elctromyography.

This study will be a cornerstone preparing for human laryngeal transplantation.

Differing from other organs, the success of vascular reanastomosis and funtional reinnervation including voice are important to laryngeal transplantation. 26 cases of the Wister rat (250-300gm) were performed. The donor's right common carotid and recipient's left common carotid artery were connected by 8 stitches 10.0 prolene. The donor's left common carotid artery and recipient's left external jugular vein were connected by 6 stitches 10.0 prolene. The recurrent laryngeal nerves were connected by 1 stitch 10.0 prolene. The last two cases which showed reinnervation were connected by 1 stitch with vein graft.

The results were as follows;

1) 2cases died within 2 hours.

2) 4 cases died within 2 weeks.

3) 13 cases which can be followed for 3 monthes.

7 cases lost donor larynx.

3 cases showed severe muscular atrophy.

1 case showed intact external appearance, but did not reinnervated.

The last 2 cases showed spontaneous movement and reinnervation was identified through glycogen depletion and elctromyography.

This study will be a cornerstone preparing for human laryngeal transplantation.