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[热缺血损伤对大鼠非心脏跳动供体肝移植肝活力及移植后结局的影响]

[The influence of warm ischemia injury on viability and posttransplantative outcome of liver graft from non-heart-beating donor in rats].

作者信息

He Xiao-shun, Ma Yi, Chen Gui-hua, Zhang Jin-xin, Wu Jin-lang, Liang Ying-jie, Lin Guang-yun, Zhu Zhen-yu, Hu Rui-de, Huang Jie-fu

机构信息

Transplantation Surgery, the First Affiliated Hospital, Sun Yet-sen University of Medical Sciences, Guangzhou 510080, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2003 Jul 25;83(14):1236-40.

Abstract

OBJECTIVE

To investigate the dynamical changes of histology, histochemistry, energy metabolism, liver function and posttransplantive survival of liver graft under different warm ischemia times (WIT) in rats and determine the maximum limitation of liver graft to warm ischemia.

METHODS

According to WIT, the rats were randomized into 7 groups, WIT were 0, 10, 15, 20, 30, 45, 60 minutes respectively. The recovery changes of above-mentioned index were observed or measured after liver transplantation. The graft survival and postoperative complications in each subgroup were analyzed.

RESULTS

Liver graft injury was reversible and gradually resumed normal structure and function after reperfusion when WIT was less than 30 minutes. In terms of graft survival, there was no significant difference between subgroups within 30 WIT. When WIT was prolonged to 45 minutes, the recipients long-term survival was severely insulted, and both function and histological structure of liver graft would develop irreversible damage when WIT was prolonged to 60 minutes.

CONCLUSION

These results indicate that rat liver graft could be safely subject to warm ischemia within 30 minutes. The levels of adentriphos (ATP) and energy charge (EC) and the activities of glycogen and enzyme-histochemistry of liver graft and its recovery potency after reperfusion may serve as the important criteria to evaluate the quality of liver graft.

摘要

目的

探讨不同热缺血时间(WIT)下大鼠肝移植术后肝组织学、组织化学、能量代谢、肝功能及移植肝存活情况的动态变化,确定移植肝对热缺血的最大耐受限度。

方法

根据WIT将大鼠随机分为7组,WIT分别为0、10、15、20、30、45、60分钟。肝移植术后观察或检测上述指标的恢复变化,分析各亚组移植肝存活情况及术后并发症。

结果

当WIT小于30分钟时,移植肝损伤是可逆的,再灌注后逐渐恢复正常结构和功能。在移植肝存活方面,WIT 30分钟内各亚组间无显著差异。当WIT延长至45分钟时,受体长期存活受到严重影响,当WIT延长至60分钟时,移植肝功能及组织结构均发生不可逆损伤。

结论

这些结果表明大鼠移植肝在30分钟内热缺血是安全的。移植肝的三磷酸腺苷(ATP)水平、能量负荷(EC)、糖原和酶组织化学活性及其再灌注后的恢复能力可作为评估移植肝质量的重要指标。

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