Straatsburg Irene H, Abrahamse Salomon L, Song Shao W, Hartman Robin J, Van Gulik Thomas M
Surgical Laboratory, Department of Surgery, Academic Medical Center, University of Amsterdam, The Netherlands.
Transplantation. 2002 Aug 27;74(4):458-64. doi: 10.1097/00007890-200208270-00005.
The benefit of Celsior in liver graft preservation is controversial. In the isolated perfused rat liver model, we compared the effects of Celsior, University of Wisconsin (UW), and histidine-tryptophan-ketoglutarate (HTK) preservation solutions on liver cell death.
Rat livers were stored at 4 degrees C for 0, 8, 16, or 24 hr in either Celsior, UW, or HTK and reperfused for 90 min (37 degrees C). Bile secretion and perfusate levels of liver enzymes and histone-associated DNA fragments were measured. Apoptosis and oncotic necrosis were analyzed in biopsies by DNA gel electrophoresis, hematoxylin and eosin histology, and enzyme histochemistry for lactate dehydrogenase (LDH) and 5'-nucleotidase (5'-NT).
Perfusate flow rate through the liver during perfusion did not significantly differ among preservation solutions. Bile secretion was best preserved in UW livers after 16-hr (versus HTK livers) and 24-hr storage (versus HTK and Celsior livers). Enzyme leakage from UW livers was lower compared with HTK livers after 8-hr storage (serum glutamic oxaloacetic transaminase [SGOT], LDH) and with Celsior and HTK livers after 16-hr (SGOT, LDH) and 24-hr storage (SGOT, serum glutamic pyruvic transaminase, LDH, purine nucleoside phosphorylase). In situ LDH and 5'-NT activities were best preserved in UW livers (up to 24 hr), whereas enzyme activities declined remarkably in HTK livers (after 8 hr) and Celsior livers (after 16 hr of cold storage). Although perfusate DNA fragment levels were repeatedly lowest from Celsior livers, apoptotic DNA laddering and the number of fragmented nuclei in hematoxylin and eosin sections was not different among livers after 8, 16, or 24 hr of storage.
Celsior and UW are equally effective in preventing rat liver cell death after 0-16 hr of cold preservation as compared with the less effective HTK solution. After 24-hr cold storage, rat livers were best preserved in UW. Furthermore, there was no significant difference in mode of cell death (apoptosis or oncotic necrosis) after storage in any of the three solutions.
赛尔西奥(Celsior)在肝移植保存中的益处存在争议。在离体灌注大鼠肝脏模型中,我们比较了赛尔西奥、威斯康星大学(UW)和组氨酸 - 色氨酸 - 酮戊二酸(HTK)保存液对肝细胞死亡的影响。
将大鼠肝脏在4℃下分别用赛尔西奥、UW或HTK保存0、8、16或24小时,然后在37℃再灌注90分钟。测量胆汁分泌以及肝酶和组蛋白相关DNA片段的灌注液水平。通过DNA凝胶电泳、苏木精和伊红组织学以及乳酸脱氢酶(LDH)和5'-核苷酸酶(5'-NT)的酶组织化学分析活检组织中的凋亡和胀亡性坏死。
灌注期间通过肝脏的灌注液流速在不同保存液之间无显著差异。在保存16小时后(与HTK肝脏相比)和24小时后(与HTK和赛尔西奥肝脏相比),UW肝脏的胆汁分泌保存最佳。在保存8小时后(血清谷氨酸草酰乙酸转氨酶[SGOT]、LDH),UW肝脏的酶泄漏低于HTK肝脏;在保存16小时后(SGOT、LDH)和24小时后(SGOT、血清谷氨酸丙酮酸转氨酶、LDH、嘌呤核苷磷酸化酶),UW肝脏的酶泄漏低于赛尔西奥和HTK肝脏。原位LDH和5'-NT活性在UW肝脏中保存最佳(长达24小时),而在HTK肝脏中(8小时后)和赛尔西奥肝脏中(冷藏16小时后)酶活性显著下降。尽管赛尔西奥肝脏的灌注液DNA片段水平反复最低,但在保存8、16或24小时后,肝脏之间凋亡DNA梯带以及苏木精和伊红切片中核碎片数量并无差异。
与效果较差的HTK溶液相比,在0至16小时的冷藏保存后,赛尔西奥和UW在预防大鼠肝细胞死亡方面同样有效。在24小时冷藏保存后,大鼠肝脏在UW中保存最佳。此外,在三种溶液中任何一种保存后,细胞死亡模式(凋亡或胀亡性坏死)均无显著差异。