Li Shiri, Suzuki Yasuyuki, Fujino Yasuhiro, Kakinoki Keiichiro, Yoshikawa Takuro, Tanaka Tomohiro, Goto Naohiro, Tanioka Yasuki, Sakai Tetsuya, Kuroda Yoshikazu
Department of Gastroenterological Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Surgery. 2006 May;139(5):646-52. doi: 10.1016/j.surg.2005.10.005.
We recently reported that the cavitary 2-layer method (cTLM) allowed stable 24-hour preservation of canine intestine. The aim of this study was to examine the possibility of the 40-hour preservation by cTLM that is supplemented with glutamine.
Canine jejunal segments (40 cm) were allotransplanted heterotopically without storage (group 1), after 40-hour cold storage with University of Wisconsin solution (group 2), cTLM (group 3), UW with 2% glutamine (group 4), or cTLM with 2% glutamine (group 5). Mucosal glutamine, histidine, tryptophan, glutathione, and adenosine triphosphate concentrations were determined immediately after preservation. At day 7 after the transplantation, maltose absorption test and histopathologic analysis were performed.
Mucosal glutamine concentrations increased significantly with glutamine supplementation during preservation in groups 4 and 5 (P < .01). Mucosal adenosine triphosphate levels in cTLM groups (groups 3 and 5) were similar to those in group 1; group 4 showed very low levels after preservation, despite glutamine supplementation. Mucosal glutathione did not differ among groups 2, 3, 4, and 5 and were significantly lower than in group 1. In the absorption test, serum glucose curves showed a peak level by 30 minutes in groups 1 and 5; delayed peaks were seen in groups 2, 3, and 4 compared with group 1. The villous heights were 879, 555, 685, 688, and 773 microm in groups 1, 2, 3, 4, and 5, respectively (group 1 vs group 2, 3, and 4: P < .05).
cTLM that was supplemented with glutamine extended a safe preservation period up to 40 hours in canine segmental small intestinal transplantation, although this study failed to elucidate a precise mechanism of the glutamine beneficial effect on the graft mucosa.
我们最近报道，空肠双层法（cTLM）可实现犬小肠24小时的稳定保存。本研究的目的是探讨补充谷氨酰胺的cTLM实现40小时保存的可能性。
将犬空肠段（40厘米）异位同种异体移植，不进行保存（第1组），用威斯康星大学溶液进行40小时冷藏后移植（第2组），用cTLM保存（第3组），用含2%谷氨酰胺的UW溶液保存（第4组），或用含2%谷氨酰胺的cTLM保存（第5组）。保存后立即测定黏膜谷氨酰胺、组氨酸、色氨酸、谷胱甘肽和三磷酸腺苷浓度。移植后第7天，进行麦芽糖吸收试验和组织病理学分析。
在第4组和第5组保存期间，补充谷氨酰胺后黏膜谷氨酰胺浓度显著升高（P <.01）。cTLM组（第3组和第5组）的黏膜三磷酸腺苷水平与第1组相似；尽管补充了谷氨酰胺，第4组在保存后水平非常低。第2、3、4和5组的黏膜谷胱甘肽无差异，且显著低于第1组。在吸收试验中，第1组和第5组血清葡萄糖曲线在30分钟时出现峰值水平；与第1组相比，第2、3和4组出现延迟峰值。第1、2、3、4和5组的绒毛高度分别为879、555、685、688和773微米（第1组与第2、3和4组比较：P <.05）。
补充谷氨酰胺的cTLM在犬节段性小肠移植中可将安全保存期延长至40小时，尽管本研究未能阐明谷氨酰胺对移植黏膜有益作用的确切机制。
