Iwane T, Akamatsu Y, Narita T, Nakamura A, Satomi S
Division of Advanced Surgical Science and Technology, Tohoku University, Miyagi, Japan.
Transplant Proc. 2006 Dec;38(10):3358-61. doi: 10.1016/j.transproceed.2006.11.002.
Our aim was to improve the energy status and viability of a liver graft from a non-heart-beating donor (NHBD), we investigated the effects of perfusion prior to cold preservation and the addition of an antioxidant, biliverdin.
Rats were divided into five groups: group 1: without 30 minutes warm ischemia (WI) and cold preservation (control group); group 2 without WI and with 6 hours of cold preservation in UW solution (HBD group); group 3 with WI and cold preservation (NHBD group); group 4 with 30 minutes perfusion prior to cold preservation (PRE group); and group 5 with addition of biliverdin to precold preservation perfusion (BV group). Oxygenated Klebs-Henseleit solution was used as the perfusate prior to and after preservation. Portal flow and bile production during reperfusion, energy charge (EC), ATP level, GOT, and TNF-alpha were measured as well as a histological evaluation.
Portal flow of the PRE and BV groups during 1 hour of reperfusion was higher than of that the NHBD group. Bile production of the PRE group was also higher than that of the NHBD group, but bile production in the BV group was comparable to the NHBD group. EC of the PRE group was higher than that of the NHBD group prior to and after reperfusion. The EC and ATP levels of the BV group after reperfusion were higher than those of the NHBD and PRE groups. The GOT and TNF-alpha were reduced in the BV group.
Precold preservation perfusion improves the viability of grafts from NHBDs. Furthermore, biliverdin exerted an additive effect to ameliorate energy status.
我们的目的是改善非心跳供体（NHBD）肝脏移植物的能量状态和活力，我们研究了冷保存前灌注以及添加抗氧化剂胆红素的影响。
将大鼠分为五组：第1组：无30分钟热缺血（WI）和冷保存（对照组）；第2组：无WI，在UW溶液中进行6小时冷保存（HBD组）；第3组：有WI和冷保存（NHBD组）；第4组：冷保存前进行30分钟灌注（PRE组）；第5组：在冷保存前灌注中添加胆红素（BV组）。保存前后均使用氧合克氏-亨氏溶液作为灌注液。测量再灌注期间的门静脉血流和胆汁生成、能量电荷（EC）、ATP水平、谷草转氨酶（GOT）和肿瘤坏死因子-α（TNF-α），并进行组织学评估。
PRE组和BV组在再灌注1小时期间的门静脉血流高于NHBD组。PRE组的胆汁生成也高于NHBD组，但BV组的胆汁生成与NHBD组相当。PRE组再灌注前后的EC均高于NHBD组。BV组再灌注后的EC和ATP水平高于NHBD组和PRE组。BV组的GOT和TNF-α降低。
冷保存前灌注可提高NHBD移植物的活力。此外，胆红素发挥了附加作用以改善能量状态。
