Mori Y, Hirose H, Murakawa S, Sakai S, Azuma K, Yamada T, Hashimoto M, Kokubo M, Umeda S
First Department of Surgery, School of Medicine, Gifu University, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1992 Jun;40(6):912-20.
University of Wisconsin (UW) solution has been reported to extend the safe cold ischemic time in the preservation of the liver, kidney and pancreas. However, there have been few reports of safe cold ischemic time in heart preservation with UW solution. The purpose of this study was to find whether UW solution can extend the safe cold ischemic time in cardiac transplantation in dogs. Heterotopic cardiac transplantation was performed in mongrel dogs after cold ischemic preservation of the hearts with UW solution, ischemic time 8, 16 and 24 hours (Gr.UW8, Gr.UW16 and Gr.UW24, respectively) and with GIK solution, ischemic time 4 hours (Gr.G4) which is considered the safe cold ischemic time in clinical cardiac transplantation. The following was studied: 1) Emax of the LV, myocardial contraction, by pressure-volume curve with the volume measured conductance catheter method, 2) myocardial tissue blood flow of the LV (MTBF), with laser doppler tissue flow meter, 3) serum CPK and electron microscopical evaluation. Emax and MTBF were measured before transplantation and after reperfusion. Their results were expressed as percentage of the values before transplantation. As results, after 120 minutes from reperfusion, Emax was recovered to 94 +/- 13% in Gr.G4, 104 +/- 11% in Gr.UW8, 67 +/- 22% in Gr.UW16 and 66 +/- 16% in Gr.UW24. Emax in Gr.G4 and Gr.UW8 were significantly (p less than 0.01) higher than that in Gr.UW16 and Gr.UW24. After 120 minutes from reperfusion, MTBF was recovered to 90 +/- 19% in Gr.G4, 98 +/- 9% in Gr.UW8, 63 +/- 19% in Gr.UW16 and 61 +/- 6% in Gr.UW24.(ABSTRACT TRUNCATED AT 250 WORDS)
据报道,威斯康星大学(UW)溶液可延长肝脏、肾脏和胰腺保存中的安全冷缺血时间。然而,关于UW溶液用于心脏保存时的安全冷缺血时间的报道却很少。本研究的目的是探究UW溶液是否能延长犬心脏移植中的安全冷缺血时间。在用UW溶液对心脏进行冷缺血保存后,对杂种犬进行异位心脏移植,缺血时间分别为8小时、16小时和24小时(分别为UW8组、UW16组和UW24组),并用GIK溶液,缺血时间为4小时(G4组),这被认为是临床心脏移植中的安全冷缺血时间。研究了以下内容:1)左心室的最大弹性(Emax),即心肌收缩,采用容积测量电导导管法通过压力-容积曲线进行测量;2)左心室心肌组织血流量(MTBF),使用激光多普勒组织流量计进行测量;3)血清肌酸磷酸激酶(CPK)及电子显微镜评估。在移植前和再灌注后测量Emax和MTBF。其结果以移植前数值的百分比表示。结果显示,再灌注120分钟后,G4组的Emax恢复至94±13%,UW8组为104±11%,UW16组为67±22%,UW24组为66±16%。G4组和UW8组的Emax显著高于UW16组和UW24组(p<0.01)。再灌注120分钟后,G4组的MTBF恢复至90±19%,UW8组为98±9%,UW16组为63±19%,UW24组为61±6%。(摘要截取自250字)