Baláz P, Matia I, Jackanin S, Rybárová Emília, Kron I, Pomfy M, Fronek J, Ryska M
Department of Transplant Surgery, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic.
Eur Surg Res. 2004 Jul-Aug;36(4):192-7. doi: 10.1159/000078852.
The two preservation solutions most commonly used in human transplantation surgery are University of Wisconsin (UW) and Custodiol (histidine-tryptophan-ketoglutarate; HTK). The aim of our study was to compare the protective effect of UW and HTK solutions on preservation-induced injury of jejunal grafts, as evaluated by the histological changes (semiquantitative method) and small bowel mucosal serotonin levels (as a possible new quantitative method).
Male Wistar rats (n = 50) weighing 316 +/- 52 g were divided into two main groups according to which preservation solution was used, i.e. UW (n = 25) or HTK (n = 25), and each of these groups was divided into five subgroups according to cold ischemic time (0, 1, 6, 9 and 12 h). Jejunal mucosa biopsy specimens were obtained to determine the serotonin concentration in mucosa and for standard light histology. To grade histological changes in mucosa, Park's small bowel injury grading system was used.
Histological examination revealed that injury increased with cold ischemic time in the UW as well as in the HTK group, and there were no significant differences in injury between the two groups, except for the 6-hour cold ischemic period (p < 0.05), when HTK-preserved grafts showed a lower degree of injury (0.97 +/- 0.41) compared with UW-preserved grafts (1.25 +/- 0.39). The mucosal serotonin concentration decreased with cold ischemic time in both groups, and there were significant differences (p < 0.05) in concentrations between the groups after 9 and 12 h of cold ischemia. A significantly higher concentration was measured in grafts preserved in UW solution at these time points.
The concentration of mucosal serotonin in rat small bowel grafts preserved for 9 and 12 h in UW preservation solution was significantly higher than that in HTK solution. These findings indicate a better protective effect of UW solution on small bowel injury after 9 h of cold ischemia.
人类移植手术中最常用的两种保存液是威斯康星大学(UW)液和科斯托迪奥尔液(组氨酸 - 色氨酸 - 酮戊二酸;HTK)。我们研究的目的是通过组织学变化(半定量方法)和小肠黏膜5-羟色胺水平(作为一种可能的新定量方法)来比较UW液和HTK液对空肠移植物保存诱导损伤的保护作用。
将体重316±52克的雄性Wistar大鼠(n = 50)根据所用保存液分为两个主要组,即UW组(n = 25)或HTK组(n = 25),并且每组根据冷缺血时间(0、1、6、9和12小时)再分为五个亚组。获取空肠黏膜活检标本以测定黏膜中的5-羟色胺浓度并用于标准光镜组织学检查。为了对黏膜的组织学变化进行分级,使用了帕克小肠损伤分级系统。
组织学检查显示,UW组和HTK组的损伤均随冷缺血时间增加,除了6小时冷缺血期外,两组之间的损伤无显著差异(p < 0.05),此时HTK保存的移植物与UW保存的移植物相比显示出较低的损伤程度(0.97±0.41)(1.25±0.39)。两组黏膜5-羟色胺浓度均随冷缺血时间降低,冷缺血9小时和12小时后两组浓度存在显著差异(p < 0.05)。在这些时间点,UW液保存的移植物中测得的浓度明显更高。
在UW保存液中保存9小时和12小时的大鼠小肠移植物中黏膜5-羟色胺浓度明显高于HTK液。这些发现表明UW液在冷缺血9小时后对小肠损伤具有更好的保护作用。