Bachmann S, Caldwell-Kenkel J C, Oleksy I, Steffen R, Thurman R G, Lemasters J J
Department of Cell Biology and Anatomy, School of Medicine, University of North Carolina, Chapel Hill 27599-7090.
Transpl Int. 1992 May;5(2):108-14. doi: 10.1007/BF00339225.
An injury to nonparenchymal cells, characterized by loss of viability of sinusoidal endothelial cells and activation of Kupffer cells, occurs after reperfusion of livers stored for transplantation. Recently, a new solution, Carolina rinse solution, was shown to prevent reperfusion injury to endothelial cells in vitro almost completely and to improve graft survival after orthotopic rat liver transplantation (ORLT) without arterialization. ORLT with arterialization permits longer cold storage of donor livers and more closely models human surgery. Therefore, we evaluated the effects of Carolina rinse solution on graft survival after ORLT with arterialization in syngeneic Lewis rats. Just prior to implantation, donor livers stored in University of Wisconsin (UW) solution were rinsed with 30 ml of Ringer's solution, saline, or Carolina rinse solution at 1 degree-4 degrees C. In livers stored for 15 h and rinsed with Ringer's or saline solution, long-term graft survival was only 8%. Using Carolina rinse solution containing 1 mmol and 200 mumol adenosine per liter, graft survival improved to 40% and 80%, respectively. Graft survival did not improve when using Carolina rinse solution with adenosine omitted or Ringer's solution containing 200 mumol adenosine per liter. Livers were also rinsed with Carolina rinse solution containing 200 mumol adenosine per liter at 28 degrees-30 degrees C rather than at 1 degree-4 degrees C. With warm Carolina rinse solution, survival improved further to 100%, 80%, and 50% after 15, 18, and 21 h of storage. After 18 h of storage, light and electron microscopy demonstrated marked denudation of the sinusoidal lining and activation of Kupffer cells in grafts rinsed with Ringer's solution.(ABSTRACT TRUNCATED AT 250 WORDS)
移植肝脏再灌注后会发生非实质细胞损伤，其特征为肝血窦内皮细胞活力丧失和库普弗细胞激活。最近，一种新的溶液——卡罗来纳冲洗液，被证明在体外几乎能完全预防内皮细胞的再灌注损伤，并能提高大鼠原位肝移植（ORLT）且未进行动脉化处理后的移植物存活率。进行动脉化处理的ORLT能使供肝进行更长时间的冷保存，且更接近人类手术情况。因此，我们评估了卡罗来纳冲洗液对同基因Lewis大鼠进行动脉化处理的ORLT后移植物存活率的影响。就在植入前，将保存在威斯康星大学（UW）溶液中的供肝在1℃至4℃下用30毫升林格氏液、生理盐水或卡罗来纳冲洗液冲洗。在保存15小时并用林格氏液或生理盐水冲洗的肝脏中，长期移植物存活率仅为8%。使用每升含1毫摩尔和200微摩尔腺苷的卡罗来纳冲洗液时，移植物存活率分别提高到了40%和80%。当省略腺苷使用卡罗来纳冲洗液或使用每升含200微摩尔腺苷的林格氏液时，移植物存活率并未提高。肝脏还用每升含200微摩尔腺苷的卡罗来纳冲洗液在28℃至30℃而非1℃至4℃下冲洗。使用温热的卡罗来纳冲洗液时，保存15、18和21小时后的存活率进一步提高到了100%、80%和50%。保存18小时后，光镜和电镜检查显示，用林格氏液冲洗的移植物中肝血窦内衬有明显剥脱，库普弗细胞激活。（摘要截选至250词）
