Aupperle H, Garbade J, Ullmann C, Krautz C, Barten M J, Dhein S, Schoon H-A, Gummert F J
Institut für Veterinär Pathologie, Universität Leipzig, An den Tierkliniken 33, 04103 Leipzig, Germany.
J Vet Med A Physiol Pathol Clin Med. 2007 Jun;54(5):230-7. doi: 10.1111/j.1439-0442.2007.00950.x.
Preserved ultrastructure is an important precondition for functional regeneration after heart transplantation. We investigated the effectiveness of a newly developed modified Langendorff system in extracorporeal heart perfusion. (Experiment I) Cardioplegia and cold ischaemia were performed in six pigs. Hearts were connected to a modified Langendorff system, and perfused with leucocyte depleted autologous blood. (Experiment II) The untreated hearts of three healthy pigs served as controls. Forty-seven myocardial biopsies at different timepoints (I: n = 29, II: n = 18) were investigated by transmission electronmicroscopy. Cardioplegia/hypothermia (I) induced mild-to-moderate mitochondrial swelling, mild myofibrillar degeneration in cardiomyocytes and moderate endothelial oedema. After 4 h reperfusion cardiomyocytes showed moderate myofibrillar and mild sarcolemmal damage. Moderate endothelial degeneration, mild interstitial oedema and haemorrhages appeared. Untreated hearts (II) showed severely damaged mitochondria and nuclei after 30 min while the myofibrillar structure remained unaffected until 4 h later. This is a promising model for extracorporeal heart perfusion. However, ultrastructural findings indicated that some necessary modifications to prevent cellular damages during reperfusion were needed.
保留超微结构是心脏移植后功能再生的重要前提条件。我们研究了一种新开发的改良Langendorff系统在体外心脏灌注中的有效性。（实验I）对6头猪进行心脏停搏和冷缺血处理。将心脏连接到改良的Langendorff系统，并用去除白细胞的自体血液进行灌注。（实验II）选取3头健康猪未处理的心脏作为对照。在不同时间点采集了47份心肌活检样本（实验I：n = 29，实验II：n = 18），并通过透射电子显微镜进行研究。心脏停搏/低温（实验I）导致线粒体轻度至中度肿胀、心肌细胞肌原纤维轻度变性以及内皮细胞中度水肿。再灌注4小时后，心肌细胞出现中度肌原纤维损伤和轻度肌膜损伤。出现中度内皮细胞变性、轻度间质水肿和出血。未处理的心脏（实验II）在30分钟后线粒体和细胞核严重受损，而肌原纤维结构直到4小时后仍未受影响。这是一个有前景的体外心脏灌注模型。然而，超微结构研究结果表明，需要进行一些必要的改进以防止再灌注期间的细胞损伤。
