Kimoto M, Shimahara Y, Ikai I, Wakashiro S, Ozaki N, Tatsumi Y, Yamaoka Y, Ozawa K
Department of Surgery, Shimane Prefectural Central Hospital, Japan.
Nihon Geka Hokan. 1992 Sep 1;61(5):396-404.
The effects of vaneless centrifugal pump (Bio-pump P-80) on energy metabolism were studied, as compared with the roller pump, in an isolated porcine liver perfused with human blood for 6 hours. According to preliminary examination, flow rates were decided to 0.4, 0.8 ml/min/g in roller pump group, in Bio-pump pump group, respectively, not to increase more than 15 mmHg in initial portal pressure. During the perfusion, actual portal pressure was measured and circulatory resistance (portal pressure/flow rate) was calculated before perfusion and hourly after perfusion. Acetoacetate, beta-hydroxybutyrate, lactate and pyruvate, were measured at same times, from which values the ketone body ratio (acetoacetate/beta-hydroxybutyrate, KBR), reflecting the redox state of liver mitochondria, was calculated. In the Bio-pump group, in spite of its high flow, circulatory resistance was low at every hour during the perfusion. KBR was increased rapidly from 0.40 to 1.39, 2.59, 2.75, 2.38, 2.41, and 1.82 and lactate was decreased rapidly from 7.96 to 3.90, 1.77, 1.29, 1.33, 1.34, and 1.25 mmol/L at the respective hours after perfusion. There were significant differences at 2 and 4 hours after perfusion in KBR and after 2 hours of perfusion in lactate as compared with the roller pump group (p < 0.05). These results suggested that the Bio-pump is available for constant and high flow to the liver and helpful to elevate the mitochondrial NAD/NADH ratio (oxidized and reduced forms of free nicotinamide-adenine dinucleotides), leading to and enhancement of metabolic capacity of the perfused liver.
在用人血灌注6小时的离体猪肝中，研究了无叶离心泵（Bio-pump P-80）与滚压泵相比对能量代谢的影响。根据初步检查，滚压泵组和Bio-pump泵组的流速分别确定为0.4、0.8 ml/min/g，初始门静脉压力升高不超过15 mmHg。在灌注过程中，测量实际门静脉压力，并在灌注前和灌注后每小时计算循环阻力（门静脉压力/流速）。同时测量乙酰乙酸、β-羟丁酸、乳酸和丙酮酸，并计算反映肝线粒体氧化还原状态的酮体比率（乙酰乙酸/β-羟丁酸，KBR）。在Bio-pump组中，尽管流速较高，但在灌注期间的每一小时循环阻力都较低。KBR在灌注后的各小时内迅速从0.40增加到1.39、2.59、2.75、2.38、2.41和1.82，乳酸则从7.96迅速降至3.90、1.77、1.29、1.33、1.34和1.25 mmol/L。与滚压泵组相比，灌注后2小时和4小时的KBR以及灌注2小时后的乳酸有显著差异（p < 0.05）。这些结果表明，Bio-pump可用于向肝脏提供恒定的高流量，并有助于提高线粒体NAD/NADH比率（游离烟酰胺腺嘌呤二核苷酸的氧化和还原形式），从而增强灌注肝脏的代谢能力。
