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[心脏骤停后获取的肾脏机器灌注中不同保存液的评估。一项实验研究]

[Evaluation of different preservation solutions utilized in the machine perfusion of kidneys retrieved under cardiac arrest. An experimental study].

作者信息

Maio Rui, Costa Paulo, Figueiredo Nuno, Santos Isa

机构信息

Clínica Universitária de Cirurgia I do Hospital de Santa Maria,Faculdade de Medicina de Lisboa, Portugal.

出版信息

Rev Port Cir Cardiotorac Vasc. 2007 Jul-Sep;14(3):149-56.

Abstract

Considering the special demands of organs retrieved after cardiac death, the solution that should optimize and preserve the best early graft function and long-term graft survival remains to be determined. Recently, polyethylene glycol (PEG), high-molecular weight colloid, due to its protective effect against ischemia and reperfusion injury, has been proposed to be added to different preservation solutions for cold storage. Celsior formulation was targeted to fulfil the principles of organ preservation. The aim of our study was to evaluate Celsior plus PEG as a machine perfusion solution for kidneys retrieved after cardiac death. Landrace pigs were killed by lethal injection. Kidneys were submitted to warm and cold ischemic injuries mimicking the injury suffered by donation after cardiac death and were machine perfused with Celsior, Celsior plus 30 mg/l of PEG 20,000 Da and Belzer MPS. We demonstrate that when kidneys, submitted to warm and cold ischemia injury, were machine perfused with Celsior plus PEG the IRR were lower and the renal flow rates were higher in comparison with Celsior alone or Belzer MPS in the same conditions. This study provides the first evidence that Celsior plus PEG is an effective solution for machine perfusion of kidneys retrieved after cardiac death.

摘要

考虑到心脏死亡后获取的器官的特殊需求,能够优化并维持最佳早期移植物功能和长期移植物存活的解决方案仍有待确定。近来,聚乙二醇(PEG),一种高分子量胶体,因其对缺血再灌注损伤的保护作用,已被提议添加到不同的冷藏保存溶液中。Celsior配方旨在满足器官保存的原则。我们研究的目的是评估Celsior加PEG作为心脏死亡后获取肾脏的机器灌注溶液的效果。采用长白猪,通过致死性注射使其死亡。对肾脏施加模拟心脏死亡后捐献所遭受损伤的温缺血和冷缺血损伤,然后分别用Celsior、含30 mg/l 20,000 Da PEG的Celsior以及Belzer多器官保存液(Belzer MPS)进行机器灌注。我们证明,在相同条件下,当对遭受温缺血和冷缺血损伤的肾脏进行机器灌注时,与单独使用Celsior或Belzer MPS相比,Celsior加PEG组的缺血再灌注损伤评分更低,肾血流速率更高。本研究首次证明Celsior加PEG是心脏死亡后获取肾脏的机器灌注的有效溶液。

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