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使用Polysol改进非心跳供体大鼠肝脏的机器灌注保存:一种新型机器灌注保存溶液

Improved machine perfusion preservation of the non-heart-beating donor rat liver using Polysol: a new machine perfusion preservation solution.

作者信息

Bessems Maud, Doorschodt Benedict M, van Marle Jan, Vreeling Heleen, Meijer Alfred J, van Gulik Thomas M

机构信息

Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.

出版信息

Liver Transpl. 2005 Nov;11(11):1379-88. doi: 10.1002/lt.20502.

Abstract

Waiting lists for transplantation have stimulated interest in the use of non-heart-beating donor (NHBD) organs. Recent studies on organ preservation have shown advantages of machine perfusion (MP) over cold storage (CS). To supply the liver with specific nutrients during MP, the preservation solution Polysol was developed. The aim of our study was to compare CS in University of Wisconsin solution (UW) with MP using UW-gluconate (UW-G) or Polysol in an NHBD model. After 30 minutes of warm ischemia, livers were harvested from rats for preservation by either CS, MP-UW-G, or MP-Polysol. After 24 hours of preservation, livers were reperfused with Krebs-Henseleit buffer (KHB). Perfusate samples were analyzed for liver damage and function. Biopsies were examined by hematoxylin and eosin staining and transmission electron microscopy. Liver damage was highest after CS compared with the MP groups. MP using Polysol compared with UW-G resulted in less aspartate aminotransferase (AST) and alanine aminotransferase (ALT) release. Perfusate flow, bile production, and ammonia clearance were highest after MP-Polysol compared with CS and MP-UW-G. Tissue edema was least after MP-Polysol compared with CS and MP-UW-G. In conclusion, preservation of the NHBD rat liver by hypothermic MP is superior to CS. Furthermore, MP using Polysol results in better-quality liver preservation compared with using UW-G.

摘要

移植等候名单激发了人们对使用非心脏跳动供体(NHBD)器官的兴趣。最近关于器官保存的研究表明,机器灌注(MP)优于冷藏(CS)。为了在机器灌注期间为肝脏提供特定营养物质,研发了Polysol保存液。我们研究的目的是在非心脏跳动供体模型中,比较威斯康星大学溶液(UW)中的冷藏与使用UW-葡萄糖酸盐(UW-G)或Polysol的机器灌注。在30分钟热缺血后,从大鼠身上获取肝脏,分别通过冷藏、UW-G机器灌注或Polysol机器灌注进行保存。保存24小时后,用克雷布斯-亨泽莱特缓冲液(KHB)对肝脏进行再灌注。对灌注液样本进行肝损伤和肝功能分析。活检组织用苏木精和伊红染色以及透射电子显微镜检查。与机器灌注组相比,冷藏后的肝损伤最高。与UW-G相比,使用Polysol的机器灌注导致天冬氨酸转氨酶(AST)和丙氨酸转氨酶(ALT)释放更少。与冷藏和UW-G机器灌注相比,Polysol机器灌注后的灌注液流量、胆汁生成和氨清除率最高。与冷藏和UW-G机器灌注相比,Polysol机器灌注后的组织水肿最少。总之,低温机器灌注保存非心脏跳动供体大鼠肝脏优于冷藏。此外,与使用UW-G相比,使用Polysol进行机器灌注可实现质量更好的肝脏保存。

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