中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (5): 815-817.doi: 10.3969/j.issn.1673-8225.2010.05.014

• 肝移植 liver transplantation • 上一篇    下一篇

低流量携氧液低温机器灌注保存供肝

王  勇1,2，赵浩亮3，韩振国3，武  帅3，张智勇4   

  1. 1山西医科大学第一临床医学院，山西省太原市   030001；2中国辐射防护研究院附属医院外科  030006；3山西医科大学附属第一医院普外科，山西省太原市 030001 ；4山西省公安109医院，山西省太原市 030006
  • 出版日期:2010-01-29 发布日期:2010-01-29
  • 作者简介:王 勇★，男，1970年生，山西省临汾市人，汉族，山西医科大学第一临床医学院硕士，副主任医师，外科主任，主要从事肝移植研究。 sxsdjh@126.com
  • 基金资助:

    课题为山西省青年科技研究基金项目（2006021048）*

Lowering the rate of perfluorochemical oxygen carrier solution to preserve liver by cold machine perfusion

Wang Yong 1,2, Zhao Hao-liang 3, Han Zhen-guo3, Wu Shuai3, Zhang Zhi-yong4   

  1. 1 First Clinical Medical College of Shanxi Medical University, Taiyuan  030001, Shanxi Province, China; 2 Department of Surgery, Affiliated Hospital of China Institute for Radiation Protection, Taiyuan  030006, Shanxi Province, China; 3 Department of Surgery, First Affiliated Hospital of Shanxi Medical University, Taiyuan  030001, Shanxi Province, China; 4 The 109 Public Security Hospital, Taiyuan  030006, Shanxi Province, China
  • Online:2010-01-29 Published:2010-01-29
  • About author:Wang Yong★, Master, Associate chief physician, First Clinical Medical College of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China; Department of Surgery, Affiliated Hospital of China Institute for Radiation Protection, Taiyuan 030006, Shanxi Province, China
  • Supported by:

    Shanxi Province Science Foundation for Youths, No.2006021048*

PDF

442

被引次数

3

摘要：

目的：观察低温机器灌注氟碳携氧液保存供肝过程中低流量因素与再灌注损伤之间的关系。
方法：成年Wistar雄性大鼠44只，随机数字表法分为正常组、对照组、实验组Ⅰ、实验组Ⅱ。切取不保存，采用 Clavien 方法行离体鼠肝循环再灌注；对照组、实验组Ⅰ、实验组Ⅱ切取的肝脏经门静脉以4.0~5.0 ℃的氟碳携氧灌注液持续灌注18 h，速度分别为0.4 ，0.2，0.1 mL/(min·g)，后行离体鼠肝循环再灌注。再灌注10，30，60 min检测再灌注流出液中丙氨酸转氨酶、天冬氨酸转氨酶活性及内皮素质量浓度，光镜和电镜下观察供肝组织病理学改变。
结果：与对照组比较，实验组Ⅰ丙氨酸转氨酶、天冬氨酸转氨酶活性和内皮素质量浓度无明显差异(P > 0.05)，实验组II丙氨酸转氨酶、天冬氨酸转氨酶活性和内皮素质量浓度明显增高(P < 0.05)。光镜和电镜下观察对照组和实验组I细胞病理形态学改变明显轻于实验组Ⅱ。
结论：氟碳携氧液低温机器灌注保存离体大鼠肝脏过程中，当灌注液流量降至0.1 mL /(min·g)时肝细胞及肝窦内皮细胞损伤严重以至于再灌注时损伤严重。

关键词: 氟碳携氧液, 流量, 低温机器灌注, 肝脏, 再灌注损伤, 肝移植

Abstract:

OBJECTIVE: To explore the association between low flow rate and reperfusion injury during the process of preserving liver by cold machine perfusing perfluorochemical oxygen carrier solution.
METHODS: Forty-four male adult Wister rats were randomly divided into normal, control, experimental Ⅰ and experimental Ⅱ groups. In the normal group, the removed liver was performed isolated reperfusion guided by Clavien method. In the other 3 groups, the removed liver was infused through the portal vein by the 4-5 ℃ conserved perfluorochemical oxygen carrier solution. The infused rate was controlled at 0.4, 0.2, 0.1 mL/(min·g) with 18 hours perfusion, After that , isolated reperfusion was performed. The activity of aspartate aminotransferase, alanine transaminase and endothelin mass concentration of the effluent was detected at minutes 10, 30, and 60 after reperfusion. The histopathological changes of liver under light and election microscopy were also observed.
RESULTS: The activity of aspartate aminotransferase, alanine transaminase and endothelin mass concentration had no remarkable differences between the experimental Ⅰ group and control group (P > 0.05). The differences between the experimental Ⅱ group and control group were remarkable (P < 0.05). The light and electron microscopy showed that the histopathological changes of liver in the control and experimental Ⅰ groups was lightener than experimental Ⅱ group.
CONCLUSION: During the process of preserving liver by cold machine perfusion, the rate of 0.1ml/(min·g) perfluorochemical oxygen carrier solution increase the injury of hepatocyte and sinusoidal endothelial cells, which eventually result in severity of reperfusion injury.

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