Okano T, Ohwada S, Nakasone Y, Sato Y, Ogawa T, Tago K, Morishita Y
Second Department of Surgery, Faculty of Medicine, Gunma University, 3-39-15 Showa-Machi, Maebashi 371-8511, Japan.
J Surg Res. 2001 Dec;101(2):157-65. doi: 10.1006/jsre.2001.6284.
This study investigated the effects of blood transfusion on liver regeneration and function after hepatectomy in rats.
Inbred male Sprague-Dawley rats underwent a sham operation or a 70% hepatectomy (PHx) and were randomly divided into seven groups according to transfusion type: groups I and II underwent a sham operation and received saline (I) or whole blood (II). Groups III to VII underwent PHx with saline (III), whole blood (IV), irradiated/leukocyte-depleted whole blood (V), plasma (VI), or autologous blood (VII). The liver regeneration rate, proliferating cell nuclear antigen (PCNA) labeling index, serum aspartate aminotransferase, alanine aminotransferase, purine nucleoside phosphorylase (PNP) activity, hepatocyte growth factor (HGF), and activated transforming growth factor beta1 (TGF-beta(1)) were measured 6 and 24 h and 5 days after PHx.
The liver regeneration rate and PCNA labeling index were lower in groups IV and V than in the other groups. Serum liver enzymes 6 h after PHx were worst in groups IV and V. PNP activity increased most in group IV, 6 and 24 h after PHx. The HGF values 6 h after PHx in all the transfused groups were lower than in group III. The activated TGF-beta(1) level 6 h after surgery was highest in group IV.
Whole blood or irradiated/leukocyte-depleted whole blood impaired liver regeneration after PHx, probably through the production of activated TGF-beta(1) and HGF outside the liver, and plasma or autologous blood reduced the deleterious effects.
本研究调查了输血对大鼠肝切除术后肝脏再生和功能的影响。
近交系雄性Sprague-Dawley大鼠接受假手术或70%肝切除术（PHx），并根据输血类型随机分为七组：第一组和第二组接受假手术，分别输注生理盐水（I组）或全血（II组）。第三组至第七组接受PHx，分别输注生理盐水（III组）、全血（IV组）、辐照/去白细胞全血（V组）、血浆（VI组）或自体血（VII组）。在PHx术后6小时、24小时和5天测量肝脏再生率、增殖细胞核抗原（PCNA）标记指数、血清天冬氨酸转氨酶、丙氨酸转氨酶、嘌呤核苷磷酸化酶（PNP）活性、肝细胞生长因子（HGF）和活化转化生长因子β1（TGF-β(1)）。
IV组和V组的肝脏再生率和PCNA标记指数低于其他组。PHx术后6小时，IV组和V组的血清肝酶水平最差。PHx术后6小时和24小时，IV组的PNP活性增加最多。所有输血组术后6小时的HGF值均低于III组。术后6小时，IV组的活化TGF-β(1)水平最高。
全血或辐照/去白细胞全血可能通过在肝脏外产生活化的TGF-β(1)和HGF而损害PHx术后的肝脏再生，而血浆或自体血可减轻有害影响。
