Post S, Menger M D, Rentsch M, Gonzalez A P, Herfarth C, Messmer K
Institute for Surgical Research, University of Munich, Germany.
Transplantation. 1992 Nov;54(5):789-94. doi: 10.1097/00007890-199211000-00005.
This study investigated the influence of hepatic arterialization on early graft function, microcirculation, and leukocyte-endothelial interaction after syngeneic orthotopic liver transplantation in Lewis rats. Livers were preserved for 17 hr in UW solution and transplanted without rearterialization (group 1: n = 10) or with immediate arterial reconstruction (group 2: n = 10). Graft function was analyzed by bile flow; microcirculation was assessed by laser Doppler flowmetry (LDF) and intravital microscopy (IVM). In addition, flow behavior of leukocytes was quantified by IVM after i.v. injection of the WBC marker acridine orange. Improved graft function in group 2 was indicated by increased bile production during the observation period of 90 min after reperfusion (7.18 +/- 0.62 vs. 3.63 +/- 0.63 ml/100 g liver [mean +/- SEM] P < 0.001). In arterialized grafts LDF values increased by 22.9 +/- 3.8% upon reperfusion of the hepatic artery (P = 0.004). Arterialization increased WBC velocities in sinusoids (group 1: 0.29 +/- 0.02 mm/sec, group 2: 0.34 +/- 0.01 mm/sec, P < 0.001) and postsinusoidal venules (0.43 +/- 0.05 vs. 0.64 +/- 0.05 mm/sec, P = 0.029). In addition, the number of nonperfused midzonal sinusoids decreased significantly (8.5 +/- 2.2% of all sinusoids analyzed vs. 4.2 +/- 1.3%, P = 0.048). However, the marked sinusoidal and venular WBC adherence observed 1 hr after reperfusion was not altered by arterialization. It is concluded that arterial reconstruction in rat liver transplantation improves microvascular perfusion and graft function but this improvement does not relate to WBC accumulation within the graft. We propose that studies on hepatic preservation and postischemic reperfusion in the rat should be based on the physiological model of dual vascularization.
本研究调查了肝动脉化对Lewis大鼠同基因原位肝移植后早期移植物功能、微循环以及白细胞与内皮细胞相互作用的影响。肝脏在UW溶液中保存17小时，然后进行移植，一组不进行再动脉化（第1组：n = 10），另一组立即进行动脉重建（第2组：n = 10）。通过胆汁流量分析移植物功能；通过激光多普勒血流仪（LDF）和活体显微镜检查（IVM）评估微循环。此外，静脉注射白细胞标记物吖啶橙后，通过IVM对白细胞的流动行为进行定量分析。再灌注后90分钟观察期内胆汁生成增加表明第2组移植物功能得到改善（7.18±0.62 vs. 3.63±0.63 ml/100 g肝脏[平均值±标准误]，P < 0.001）。在动脉化移植物中，肝动脉再灌注时LDF值增加了22.9±3.8%（P = 0.004）。动脉化使肝血窦中白细胞速度增加（第1组：0.29±0.02 mm/秒，第2组：0.34±0.01 mm/秒，P < 0.001），肝血窦后小静脉中白细胞速度也增加（0.43±0.05 vs. 0.64±0.05 mm/秒，P = 0.029）。此外，未灌注的中区肝血窦数量显著减少（分析的所有肝血窦的8.5±2.2% vs. 4.2±1.3%，P = 0.048）。然而，再灌注1小时后观察到的明显的肝血窦和小静脉白细胞黏附并未因动脉化而改变。研究得出结论，大鼠肝移植中的动脉重建可改善微血管灌注和移植物功能，但这种改善与移植物内白细胞聚集无关。我们建议，大鼠肝脏保存和缺血后再灌注的研究应基于双血管化的生理模型。
