Harms J, Schneider A, Baumgartner M, Henke J, Busch R
Institute of Minimal Invasive Interdisciplinary Therapeutical Intervention, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, 81675, München, Germany.
Biosens Bioelectron. 2001 May;16(3):169-77. doi: 10.1016/s0956-5663(00)00145-7.
Diagnosis of acute rejection is a complex and persistent problem in liver transplantation. Focused on the use of proprietary impedance technology a porcine liver model was designed to provide immediate information for differentiation of normal and acute rejecting tissue by an implantable telemetric device.
Electrical impedance was analyzed by electrodes implanted in vitro and in vivo in the liver of pigs, where impedance is derived from measurements of voltage transients produced in response to programmed current pulses. Consequent electric recordings in porcine livers after transplantation and after mere laparotomy were evaluated in relation to biochemical parameters and histological results of liver biopsies.
Acute rejection was correctly predicted in all cases and correctly excluded in the remaining 32 biopsy related impedance recordings (P<0.004). Impedance measurements not only correlated with the diagnosis from liver biopsy specimen (r=0.84, P<0.0001) but also exemplified the severity of histological acute rejection.
Impedance analysis reveals evident physiologic relation of acute liver graft rejection and electrical organ properties. Electrodes implanted in transplanted porcine livers allow running less invasive monitoring and thus early detection of rejection. The technology may have broad value in providing an immediate diagnosis of acute rejection, reducing unnecessary patient anxiety and eliminating the significant expenses associated with multiple referrals, expensive sample handling and tissue analysis.
急性排斥反应的诊断在肝移植中是一个复杂且长期存在的问题。基于专有阻抗技术的应用，设计了一种猪肝模型，旨在通过植入式遥测设备为区分正常组织和急性排斥组织提供即时信息。
通过将电极植入猪肝脏的体外和体内来分析电阻抗，其中阻抗源自对编程电流脉冲产生的电压瞬变的测量。将移植后和单纯剖腹术后猪肝脏的后续电记录与肝活检的生化参数和组织学结果相关联进行评估。
在所有病例中均正确预测了急性排斥反应，并且在其余32次与活检相关的阻抗记录中正确排除了急性排斥反应（P<0.004）。阻抗测量不仅与肝活检标本的诊断相关（r=0.84，P<0.0001），还例证了组织学急性排斥反应的严重程度。
阻抗分析揭示了急性肝移植排斥反应与器官电学特性之间明显的生理关系。植入移植猪肝中的电极允许进行侵入性较小的监测，从而早期检测排斥反应。该技术在提供急性排斥反应的即时诊断、减少患者不必要的焦虑以及消除与多次转诊、昂贵的样本处理和组织分析相关的巨额费用方面可能具有广泛的价值。
