Kinasiewicz A, Fiedor P
Department of General and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland.
Transplant Proc. 2003 Sep;35(6):2345-6. doi: 10.1016/s0041-1345(03)00795-4.
Occurrence of primary graft nonfunction of pancreatic islets demands research for new methods of organ preservation during cold ischemia conditions. Digestive enzymes released during preservation injure the islets for subsequent rewarming and islet isolation processes. The aim of our study was to assess the amylase level in preservation solution as a marker of exocrine tissue injury, allowing the prognosis of islet yield and viability. The experiments undertaken on rats used three commercially available preservation solutions: ViaSpan (UW); Custodiol (HTK); and Euro-Collins (EC). After 180 minutes of cold ischemia, the highest islet recovery was observed among pancreata stored in UW solution (508 +/- 139 vs HTK 344 +/- 103; P <.05 vs EC 322 +/- 113; P <.05). These islets also revealed the highest insulin stimulation index in glucose static tests (1.19 +/- 0.30 vs HTK, 0.87 +/- 0.43; P <.01, vs EC.25 +/-.06; P <.001). The highest amylase level in the preservation solution was associated with a decreased yield of islets during the isolation process and lowest insulin stimulation index (increasing 139 +/- 18% for EC, 108 +/- 12% for HTK; P <.05 vs 87 +/- 10% for UW; P <.05). Our data strongly suggest, that the dynamic of amylase release during pancreas preservation at 4 degrees C correlates with a reduced number and viability of isolated islets. These results suggest that measurement of amylase levels after pancreas preservation may have potential clinical application as a marker to evaluate pancreatic tissue injury.
胰岛原发性移植无功能的发生需要研究在冷缺血条件下器官保存的新方法。保存过程中释放的消化酶会损害胰岛,影响后续的复温和胰岛分离过程。我们研究的目的是评估保存液中的淀粉酶水平,将其作为外分泌组织损伤的标志物,从而对胰岛产量和活力进行预后评估。在大鼠身上进行的实验使用了三种市售的保存液:ViaSpan(UW)、Custodiol(HTK)和Euro-Collins(EC)。冷缺血180分钟后,在UW溶液中保存的胰腺中观察到最高的胰岛回收率(508±139,而HTK为344±103;与EC的322±113相比,P<.05)。在葡萄糖静态试验中,这些胰岛还显示出最高的胰岛素刺激指数(1.19±0.30,而HTK为0.87±0.43;P<.01,与EC的0.25±0.06相比,P<.001)。保存液中最高的淀粉酶水平与分离过程中胰岛产量降低以及最低的胰岛素刺激指数相关(EC增加139±18%,HTK增加108±12%;与UW的87±10%相比,P<.05)。我们的数据有力地表明,4℃胰腺保存过程中淀粉酶释放的动态变化与分离的胰岛数量减少和活力降低相关。这些结果表明,胰腺保存后淀粉酶水平的测量可能具有潜在的临床应用价值,可作为评估胰腺组织损伤的标志物。