异氟醚吸入麻醉对不同年龄组消化道恶性肿瘤患者血液流变学影响的临床研究

目的 观察异氟醚吸入麻醉对不同年龄组消化道恶性肿瘤患者血液流变学的影响,并对观察结果进行比较、分析,为临床吸入麻醉药物的选择提供依据.方法 自2009年2月～2010年11月于泸州医学院附属医院选择ASA Ⅰ～Ⅱ级、行择期胃癌、直肠癌、结肠癌根治手术的患者50例,其中男29例,女21例,年龄37岁～73岁,根据年龄不同分为老年组(≥65岁)23例和中青年组(＜65岁)27例.诱导麻醉成功气管插管后,持续以异氟醚(3％～5％)、瑞芬太尼0.05 μg·kg-1·min-1～0.2 μg· kg-1· min-1、维库溴铵1 μg· kg-1· min-1维持麻醉.所有患者分别在麻醉输液实施前(T0)、最低肺泡有效浓度(MAC)达到1～1.3时并维持1h(T1)、停吸入麻醉时(T2)、人麻醉后监测治疗室(postanesthesia care unit,PACU)后30min(T3)4个时间点各采血5ml,全自动血液流变快测仪测定高切变率全血黏度(Hηb)、中切变率全血黏度(Mηb)、低切变率全血黏度(Lηb)、血浆粘度(ηp)应用FASCO3010血流变分析软件计算全血还原黏度(ηr)、红细胞聚集指数(erythrocyte aggregation index,EAI)、红细胞变形指数(erythrocyte deformation index,EDI)、红细胞刚性指数(erythrocyte rigidity index,ERI)等血液流变学指标.结果 老年组患者与中青年组患者之间,T0点两组各个血液黏度指标皆无统计学差异.而Hηb、Mηb、Lηb以及ηr在T2皆存在统计学差异(F=7.05,7.27,7.71,5.07,P＜O.05)；Mηb、Lηb在L仍存在统计学差异(F=7.22,7.79,P＜0.01).EAI在T2有统计学差异(F=5.82,P＜0.05),在T3时存在统计学差异(F=8.79,P＜O.01).EDI在随后各个时间点皆无统计学差异.ERI在T3时存在统计学差异(F=4.26,P＜0.05).血沉方程K值在各个时间点两组之间皆无统计学差异. 结论 异氟醚麻醉对老年消化道恶性肿瘤患者血液流变学影响比较平缓,与老年组比较能明显降低中青年组消化道恶性肿瘤患者的血液黏度,异氟醚麻醉是一种安全的吸入麻醉药物.     

微量肝素对老年患者术后血液流变性的影响

目的探讨微量肝素对老年患者术后48 h内血液流变性的影响。方法全麻腹部手术患者40例,年龄60~75岁,随机均分为肝素组(H组)和对照组(C组)。H组术后输注肝素5 mg(加入5%葡萄糖溶液500 ml),3~4 h滴完,2次/天,连续使用2 d。记录麻醉前5 min(T1)、术后1 h(T2)、6 h(T3)、24 h(T4)、48 h(T5)的高切变率全血粘度(Hηb)、低切变率全血粘度(Lηb)、血浆粘度(ηp)、全血还原粘度(ηr)、红细胞聚集指数(EAI)、红细胞变形指数(EDI)、红细胞刚性指数(ERI)、红细胞压积(Hct)、红细胞沉降率(ESR)、红细胞电泳时间(EET)。结果与T1时比较,T3~T5时H组Hηb、Lηb、ηr、EAI、ERI、EET明显降低(P<0.05),T4、T5时ηp也明显降低(P<0.05),T5时H组Hηb、Lηb、ηp、ηr、ERI、EET明显低于C组(P<0.05)。结论老年患者术后早期使用微量肝素治疗可改善血液流变性。     

宫颈癌患者术前辅助化疗和不同麻醉方法对血液流变学的影响

目的观察术前辅助化疗宫颈癌患者和不同麻醉方法对其血液流变学的影响。方法选择60例宫颈癌患者,分为A、B两组,每组30例。A组为化疗组,术前接受过三个疗程的化疗;B组为非化疗组,术前未给予化疗。A、B组又随机分为两个亚组,每组15例:A1、B1组行全麻复合硬膜外麻醉;A2、B2组行单纯全麻。所有患者均于麻醉诱导前5min、麻醉诱导后60min、手术结束时分别抽取外周静脉血5ml行血液流变学各项指标的检测。结果与B组比较,术前A组红细胞变形指数(EDI)降低、刚性指数(ERI)及全血粘度升高(P0.05)。与麻醉诱导前5min比较,麻醉诱导后60min、手术结束时A1、B1组EDI增加,血浆粘度(ηP)、Hct和红细胞聚集指数(EAI)均明显降低(P0.01);而A2、B2组Hct降低。结论宫颈癌患者术前辅助化疗后存在以红细胞变形力下降为特征的血液流变学变化。全麻复合硬膜外麻醉能明显改善血液流变参数,可为临床提供参考。     

阴茎勃起功能障碍患者血液流变学分析

目的 探讨阴茎勃起功能障碍（ED）患者血液流变学参数的临床意义。方法 对43例ED患者和20例阴茎勃起正常对照者血液流变学参数进行对照分析。结果 ED组全血低切粘度（η10）、血浆粘度（ηp）、红细胞聚集指数（CE）、全血还原粘度（ηw）、血沉方程K值（K）明显高于对照组（P＜0．05）,内分泌性ED组红细胞刚性指数（IP）明显高 于心理性、动脉性、静脉性ED组（P＜0．05）,心理性EC组红细胞压积（HCT）明显高于内分泌性、静脉性、动脉性组（P＜0．05） ,差别均有显著性意义。结论 ED患者血液呈高粘滞性,降低血液粘稠度可能有助于患者勃起功能的改善。     

两种麻醉方法用于老年人腹腔镜胆囊切除术维持期间血流动力学的变化

目的观察丙泊酚复合雷米芬太尼、七氟醚复合雷米芬太尼两种麻醉方法用于老年人腹腔镜胆囊切除术维持期间血流动力学指标的变化。方法50例拟在气管插管全麻下择期行腹腔镜胆囊切除术的老年病人（年龄≥60岁）随机分为丙泊酚组（P组）和七氟醚组（S组）两组,每组25例。快速诱导后经口插入气管导管,麻醉维持P组采用0．1mg·kg^-1·min^-1丙泊酚和1μg·kg^-1·min^-1雷米芬太尼静脉泵入,S组采用3％～4％七氟醚吸入和1μg·kg^-1·min^-1雷米芬太尼静脉泵入。于麻醉诱导后10min、手术开始后30、45、60min以及术毕30min记录平均动脉压（MAP）、中心静脉压（CVP）、心排血量（CO）、心脏指数（CI）和外周血管阻力（SVR）等血流动力学指标值。结果临床麻醉剂量的丙泊酚复合雷米芬太尼、七氟醚复合雷米芬太尼对病人血流动力学指标的影响均较轻,两组间血流动力学指标的差异无统计学意义。结论两种麻醉方法对老年人腹腔镜胆囊切除术维持期间心血管功能的影响程度相似。     

倍他洛克用于气管插管期对BIS，ICP和血流动力学的影响

目的：观察长效选择性β受体阻滞剂—倍他洛克（metoprolol．美托洛尔）对丙泊酚麻醉诱导气管内插管期的BIS、ICP和血流动力学影响。方法：随机选择鼻蝶入路垂体瘤切除术病人100例，ASAⅠ-Ⅱ级，分为倍他洛克组（工组）和对照组（Ⅱ组），每组50例。工组於麻醉诱导期静脉注射倍他洛克60μg／kg；Ⅱ组静脉注射等容量生理盐水。麻醉诱导采用丙泊酚2mg/kg、芬太尼3μg／kg、罗库溴铵1mg／kg，OSS／A评分0级施行气管内插管．术中持续监测平均动脉压（MAP），心率（HR），颅内压（ICP）和脑电双频谱指数（BIS）。结果：倍他洛克组与对照组在气管插管后1min时的BIS分别为39±11和58±8，前者与插管前相比无显着性改变，而后者则较插管前有明显增高并延续至插管后5min（P〈0.05，P〈0.01），且其组间的显着性差异延续至插管后15min（P〈0.01）．倍他洛克组与对照组的MAP和HR在插管后3min和5min，均较插管前明显上升，对照组HR分别为89±11bpm和76±12bpm，MAP分别为122±16mmHg和106±18mmhg，倍他洛克组HR分别为81±12bpm和74±8bpm，MAP分别为111±18mmHg和97±17mmHg。两组相比，对照组的血流动力学显着性上升（P〈0.01），且其组间的显着性差异延续至插管后30min（P〈0.05，P〈0，01）。对照组的ICP於插管后3min上升为14．0±2.3mmHg，舆插管前相比有显着性差异（P〈0．05）；插管后5min，15min和30min的ICP分别为14.9±．0mmHg，15．5±2．6mmHg和14.4±2.7mmHg，显着性高於倍他洛克组（P〈0．05，P〈0．01）．两组插管后的ICP舆麻醉前比较均有显着性升高（P〈0。01）。结论：倍他洛克能减低麻醉诱导气管插管期的血流动力学波动和ICP升高，并抑制DIS反跳．     

自身输血对血液流变学和内环境的影响

目的 观察自身输血后血液流变学相关指标变化以及血气指标变化.方法 选择出血量超过500 ml手术患者共42例,ASA Ⅰ或Ⅱ级,随机分为两组：观察组22例,分别于麻醉前和回输完自体血液后30 min抽取股动脉和股静脉血液;对照组20例,分别于麻醉前和异体血液输完后30 min抽血,即刻送检血液流变学和血气分析.结果 与麻醉前比较,输血后对照组血沉加快,红细胞压积降低;观察组血沉加快,而红细胞压积变化差异无统计学意义;观察组pH值和SB显著降低（P＜0.01）,PaCO2升高（P＜0.05）,BE和缓冲碱降低（P＜0.05）;对照组BE显著降低（P＜0.01）,pH值和SB显著降低（P＜0.05）.结论 自身输血对血液流变学无显著影响.     

全麻诱导中右旋美托咪定的镇静效应及对丙泊酚用量的影响

目的研究全麻诱导中右旋美托咪定（Dex）的镇静效应及对丙泊酚用量的影响。方法选择30例择期全麻手术患者,ASAⅠ或Ⅱ级,随机分成Dex组（D组）和对照组（C组）,每组15例。D组以1μg/kgDex稀释成10ml、C组以生理盐水分别静脉泵注10min,给药后20min泵注丙泊酚0.4mg·kg-1.min-1,托下颌无体动时给予芬太尼1μg/kg和罗库溴铵0.6mg/kg,1.5min后进行气管内插管。记录用药前（T0）、用药后5min（T1）、10min（T2）、20min（T3）的反应指数（RE）、状态指数（SE）、Ramsay评分。记录睫毛反射消失时丙泊酚最小诱导量和丙泊酚诱导总用量。结果 T1～T3时D组SE、RE显著低于C组和T0时（P〈0.01）,Ramsay评分明显高于C组和T0时（P〈0.01）。D组丙泊酚最小诱导量和诱导总量明显低于C组（P〈0.01）。结论 Dex1μg/kg诱导可以产生明显的镇静效应,无呼吸抑制作用,可减少诱导时丙泊酚用量。     

羟乙基淀粉溶液对腹腔镜胆囊切除患者血液流变学特性的影响

目的 观察腹腔镜气腹及术中使用羟乙基淀粉130/0.4溶液对腹腔镜胆囊切除患者血液流变学特性的影响。 方法 60名腹腔镜胆囊切除术患者于术前、建立气腹后、使用HES 130/0.4溶液（对照组使用林格氏液）后、术后四个时间点检测全血粘度（WBV）、血浆粘度（PV）、红细胞压积（HCT）、血沉（ESR）、血沉方程K值（ESR K）、红细胞刚性指数（RI）、红细胞聚集指数（EAI ）。 结果 建立气腹后患者WBV、PV、RI、EAI均较术前明显升高;使用HES 130/0.4溶液后,患者WBV、HCT、EAI、ESR K明显下降,治疗组较对照组下降幅度大;术后非老年患者指标恢复正常,但老年患者WBV、PV、HCT、EAI仍有升高。 结论 腔镜手术中气腹影响患者特别是老年患者血液流变学特性,而术中使用HES 130/0.4溶液可以有效降低血液粘度、改善微循环。     

阳萎患者血液流变学的研究

目的 从血液流变学角度进一步探讨各类阳萎的发病机制。方法 对４３例各类阳萎患者（阳萎组）和２０例正常对照者（对照组）进行血液流变学指标对照研究,其中包括全血低切粘度（１０ｓ＾－１）、全血高切粘度（１００ｓ＾－１）、血浆粘度（ηｐ）、红细胞压积（ＨＣＴ）、血沉（ＥＳＲ）、红细胞聚集指数（ＣＥ）、红细胞刚性指数（ＩＲ）、全血还原粘度（ηｗ）、血沉方程Ｋ值。结果 阳萎组１０ｓ＾－１、ηｐ、ＣＥ、Ｋ值、η     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.     

Immunomodulation in Transplantation with Photopheresis

Abstract: Photopheresis is a technique in which peripheral blood mononuclear cells, in the presence of a photoacti-vatable compound, are exposed extracorporeally to ultraviolet A light and reinfused, inducing a host autoregula-tory immune response. Experimental work and ongoing clinical studies are helping to define the role of this novel, safe, and non-toxic immunomodulating technology in the field of transplantation.