Stegemann Judith, Hirner Andreas, Rauen Ursula, Minor Thomas
Surgical Research Division, University Clinic of Surgery, Sigmund Freud Str. 25, 53127 Bonn, Germany.
Institute of Physiological Chemistry, University Hospital Essen, Germany.
Cryobiology. 2009 Feb;58(1):45-51. doi: 10.1016/j.cryobiol.2008.10.127. Epub 2008 Oct 17.
The aim of the present study was to evaluate the potential benefit of two different techniques for the provision of tissue aerobiosis upon cold preservation of marginal livers from non-heart beating donors using a recently developed improved preservation solution. Rat livers were harvested 30 min after cardiac arrest, flushed via the portal vein and cold-stored in HTK or modified HTK-solution (Custodiol-N) for 18 h at 4 degrees C. Other organs were flushed with Custodiol-N and subjected to aerobic conditions by either vascular systemic oxygen persufflation (VSOP) of the cold stored organ or hypothermic machine perfusion (HMP) with oxygenated Custodiol-N. Viability of the livers was assessed after 18 h of preservation by warm reperfusion in vitro for 120 min. Free radical mediated lipid peroxidation was significantly abrogated by the use of Custodiol-N in all groups compared with HTK. Custodiol-N improved enzyme leakage upon reperfusion and histological integrity, but had no impact on functional recovery (bile production, energetic status). However, VSOP further minimized enzyme release during the whole reperfusion period, led to a rise in hepatic bile production and enhanced recovery of energy charge (p<0.05, resp. vs Custodiol-N). Histological appearance was concordantly improved in VSOP. During the first 45min of reperfusion, leakage of ALT and LDH was also reduced by MP but deteriorated thereafter and became significantly higher compared to Custodiol-N at the end of the experiment. In conclusion, the results of the present study recommend the use of gaseous oxygen persufflation to improve tissue integrity and functional recovery of predamaged livers.
本研究的目的是评估使用最近开发的改良保存溶液，在对非心脏跳动供体的边缘性肝脏进行冷保存时，两种不同的组织有氧处理技术的潜在益处。在心脏骤停30分钟后采集大鼠肝脏，通过门静脉冲洗，并在4℃下于HTK或改良的HTK溶液（Custodiol-N）中冷藏18小时。其他器官用Custodiol-N冲洗，并通过对冷藏器官进行血管系统氧吹入（VSOP）或用含氧的Custodiol-N进行低温机器灌注（HMP）使其处于有氧条件。在保存18小时后，通过体外温血再灌注120分钟评估肝脏的活力。与HTK相比，在所有组中使用Custodiol-N可显著减轻自由基介导的脂质过氧化。Custodiol-N改善了再灌注时的酶泄漏和组织学完整性，但对功能恢复（胆汁分泌、能量状态）没有影响。然而，VSOP进一步使整个再灌注期间的酶释放降至最低，导致肝胆汁分泌增加，并提高了能量电荷的恢复（分别与Custodiol-N相比，p<0.05）。VSOP组的组织学外观也相应得到改善。在再灌注的前45分钟，MP也减少了ALT和LDH的泄漏，但此后恶化，并且在实验结束时与Custodiol-N相比显著更高。总之，本研究结果推荐使用气态氧吹入来改善受损肝脏的组织完整性和功能恢复。
