Vuković R, Simić M, Tasić M, Zivojinović S
Institut za sudsku medicinu, Medicinski fakultet, Novi Sad.
Med Pregl. 1992;45(5-6):184-7.
Thirty-minute normothermic liver ischemia causes swelling of the hepatocytes and sinusoid wall cells, their individual necrosis and discharge of the glycogen supply in the hepatocytes. The swelling of the hepatocytes and of the sinusoid wall cells causes a significant reduction of the liver lobe sinusoid volume which decreases from 27.6% to 5.4%, representing, actually, one fifth of the normal value. Such finding was recorded as a critical vascular liver volume, because any further decrease of the sinusoid volume would inevitably lead toward manifest and persisting portal hypertension which evidently interferes with Bernoulli trial of the hepatitic perfusion. The obtained data determine morphofunctional relevancy of the liver allograft for transplantation and are useful for all other surgical interventions requiring partial resection of this organ or time limited regional and total ischemia.
30分钟的常温肝缺血会导致肝细胞和肝血窦壁细胞肿胀、单个细胞坏死以及肝细胞内糖原储备的释放。肝细胞和肝血窦壁细胞的肿胀导致肝叶肝血窦体积显著减小,从27.6%降至5.4%,实际上仅为正常值的五分之一。这一发现被记录为肝脏关键血管容积,因为肝血窦容积的任何进一步减小都将不可避免地导致明显且持续的门静脉高压,这显然会干扰肝脏灌注的伯努利试验。所获得的数据确定了用于移植的同种异体肝移植物的形态功能相关性,并且对所有其他需要部分切除该器官或限时区域性和完全性缺血的外科手术干预均有用处。