Ricciardi Rocco, Foley David P, Quarfordt Steven H, Donohue Susan E, Wheeler Suzanne M, Callery Mark P, Meyers William C
Department of Surgery, University of Massachusetts Medical School, Worcester, MA 01655, USA.
J Gastrointest Surg. 2002 Mar-Apr;6(2):248-54. doi: 10.1016/s1091-255x(01)00065-8.
Reperfusion of support livers after cold preservation produces hemodynamic instability (i.e., postreperfusion syndrome) in the recipient during both orthotopic liver transplantation and extracorporeal liver perfusion. We evaluated the effect of the normal porcine cold-preserved support liver on healthy recipient hemodynamics and in situ liver function during extracorporeal liver perfusion. Support livers were harvested from Yorkshire pigs and reperfused in an extracorporeal circuit with a healthy, anesthetized recipient pig. Correlation analyses were performed between support liver variables of function (oxygen consumption, bile flow, and biliary phospholipid and cholesterol output) and both recipient hemodynamic stability (heart rate, blood pressure, urine output, and vasopressor use) and hepatic function (bile flow and biliary phospholipid secretion). The data indicate that optimally functioning support livers are associated with improved recipient hemodynamic stability manifested by decreased recipient heart rate and vasopressor use and increased recipient urine output. Support livers exhibiting poor biliary secretory function (i.e., bile flow and phospholipid output) were associated with similarly diminished recipient liver biliary secretory function. These data indicate that the functional condition of the support liver after harvest and cold preservation may influence both recipient hemodynamic parameters and the endogenous function of the recipient liver.
在原位肝移植和体外肝灌注过程中，冷保存后的供肝再灌注会使受体出现血流动力学不稳定（即再灌注综合征）。我们评估了正常猪冷保存供肝在体外肝灌注期间对健康受体血流动力学和原位肝功能的影响。从约克夏猪获取供肝，并在体外循环中与健康的麻醉受体猪进行再灌注。对供肝功能变量（氧消耗、胆汁流量以及胆汁中磷脂和胆固醇输出量）与受体血流动力学稳定性（心率、血压、尿量和血管升压药使用情况）及肝功能（胆汁流量和胆汁磷脂分泌）进行相关性分析。数据表明，功能最佳的供肝与受体血流动力学稳定性改善相关，表现为受体心率降低、血管升压药使用减少以及受体尿量增加。胆汁分泌功能较差（即胆汁流量和磷脂输出量）的供肝与受体肝脏胆汁分泌功能同样降低有关。这些数据表明，获取和冷保存后的供肝功能状况可能会影响受体血流动力学参数以及受体肝脏的内源性肝功能。
