Saad S, Minor T, Nagelschmidt M, Fu Z X, Kötting I, Paul A, Troidl H, Isselhard W
II. Lehrstuhl für Chirurgie, Universität Köln.
Langenbecks Arch Chir Suppl Kongressbd. 1998;115(Suppl I):705-8.
The experimental study investigates the resuscitation of livers procured from non heart beating donors by venous systemic oxygen persufflation in a pig transplantation model. In group 1 livers were harvested from donor animals after 60 min of potassium induced cardiac arrest. Livers were then flushed and preserved in 4 degrees C cold University of Wisconsin solution for 4 hrs. Then liver transplantation was performed in recipient animals. Animals of group 2 received the same treatment, but during hypothermic storage we applied venous systemic oxygen gas persufflation (VSOP) via the supra-hepatic vena cava. Livers of group 3 were harvested without warm ischemia and without oxygen treatment during cold ischemic storage and were then transplanted. All recipient animals of group 2 and 3 survived the five day follow-up time. All recipient animals of group 1 died a few hours after liver reperfusion due to circulatory shock or liver failure. The liver quality of group 2 recipient animals was similar to group 3 livers, because serum transaminase levels and blood coagulation test showed no significantly different values between those groups. Our data suggest that livers procured from non heart beating donors after 1 hr of cardiac arrest can be resuscitated and successfully transplanted by therapeutic treatment with VSOP.
该实验研究在猪移植模型中,通过静脉全身氧灌注来探究从非心脏跳动供体获取的肝脏的复苏情况。在第1组中,在钾诱导心脏骤停60分钟后从供体动物身上获取肝脏。然后将肝脏冲洗并在4℃冷的威斯康星大学溶液中保存4小时。随后在受体动物中进行肝移植。第2组动物接受相同的处理,但在低温保存期间,我们通过肝上腔静脉进行静脉全身氧灌注(VSOP)。第3组的肝脏在冷缺血保存期间未经历热缺血且未进行氧处理,然后进行移植。第2组和第3组的所有受体动物均存活至五天的随访期结束。第1组的所有受体动物在肝再灌注后数小时因循环性休克或肝衰竭死亡。第2组受体动物的肝脏质量与第3组肝脏相似,因为血清转氨酶水平和凝血试验显示这些组之间的值无显著差异。我们的数据表明,心脏骤停1小时后从非心脏跳动供体获取的肝脏可通过VSOP治疗性处理进行复苏并成功移植。