Effect of Pretransplant Donor-specific Blood Transfusion on Cardiac Allograft Survival in Rats / 대한흉부외과학회지

BACKGROUND: Donor-specific blood transfusion(DSBT) before organ transplantation has been demonstrated to prolong allograft survival; the mechanism of this effect has remained unclear. Only a few researches have been performed on this subject in our country. MATERIAL AND METHOD: To investigate the effect of DSBT, we selected 5 donor recipient combinations using rats of pure strain such as PVG, ACI, and LEW. One ml of donor whole blood was transfused to each recipient through the femoral vein 7 days prior to transplantation. The donor heart was transplanted to the recipient's abdominal vessels heterotopically using modified Ono and Lindsey's microsurgical technique. Five transplantations were done for each combination. Postoperatively, donor heart beat was palpated everyday through the recipent's abdominal wall. Rejection was defined as complete cessation of donor heart beat. RESULT: The allogeneic heart grafts transplanted from PVG strain to ACI strain(PVG ACI) without DSBT were acutely rejected(mean survival 10.2 days). With pretransplant DSBT, the cardiac allografts in PVG ACI and LEW PVG combinations survived indefinitely(more than 100 days), those in ACI PVG combination survived 12 to 66 days(mean 31.8 days), those in PVG LEW survived 8 to 11 days(mean 10.0 days), and those in ACI LEW survived 7 to 9 days(mean 8.0 days). In brief, DSBT prior to heart transplantation was definitely effective in PVG ACI and LEW PVG combinations and moderately effective in ACI PVG combination, but not effective in PVG LEW and ACI LEW combinations. CONCLUSION: DSBT prior to heart transplantation showed variable effects, but might prolong cardiac allograft survival indefinitely in some donor recipient strain combinations. The mechanism of this effect should be further investigated.

Limited Sympathetic Nervelipping of T2 Sympathetic Chain Block for Essential Hyperhidrosis / 대한흉부외과학회지

BACKGROUND: Conventional thoracoscopic thoracic sympathectomy or sympathicotomy is an effective method in treating localized hyperhidrosis; however, this may result in a postoperatively embarrassing compensatory hyperhidrosis or facial anhidrosis in the treatment of palmar hyperhidrosis. We modified the conventional sympathicotomy by limiting the extent of nerve transection. The purpose of this study was to assess the result of the limited thoracoscopic sympathetic nerve transection in hyperhidrosis. MATERIAL AND METHOD: From May to August 1998, 17 patients underwent limited transection of the sympathetic nerve. For 9 patients with facial hyperhidrosis, we transected only the interganglionic fiber between the first and the second ganglion, whereas the conventional method cuts two interganglionic fibers. Eight patients with palmar hyperhidrosis underwent limited transection of the interganglionic fiber between the second and third ganglion. RESULT: Sixteen patients had improved symptom postoperatively. There was a recurred facial sweating in 1 patient 1 month after the operation. Among the 9 facial hyperhidrosis patients, postoperative compensatory hyperhidrosis was severe in 4, moderate in 4 and minimal in 1. But in 8 cases of palmar hyperhidrosis compensatory hyperhidrosis was moderate in 3, and minimal in 1, none in 4. Facial sweating was not disturbed postoperatively in all of the palmar hyperhidrosis patients. CONCLUSION: Limited sympathetic nerve transection is a practical and less invasive method for the treatment of localized hyperhidrosis and may reduce the incidence of compensatory truncal hyperhidrosis and facial anhidrosis in case of palmar hyperhidrosis.