Zatschler Birgit, Dieterich Peter, Müller Bianca, Kasper Michael, Rauen Ursula, Deussen Andreas
Department of Physiology, Medical Faculty Carl Gustav Carus, TU Dresden, Germany.
J Vasc Surg. 2009 Aug;50(2):397-406. doi: 10.1016/j.jvs.2009.04.064.
Cold storage of arteries for reconstructive and bypass surgery may result in injury of endothelial cells which may promote low perfusion and graft vasculopathy.
A recently developed N-acetyl histidine-buffered, potassium-chloride enriched, and amino acid-fortified vascular storage solution augmented with iron chelators deferoxamine (100 micromol/L) and LK 614 (20 micromol/L) was studied in the rat superior mesenteric artery and aorta with respect to: (1) potassium-induced vessel tone, (2) endothelium-dependent and -independent relaxation, and (3) endothelial nitric oxide synthase (eNOS) protein expression over 4-days cold storage (4 degrees C).This solution was compared with traditional storage solutions, histidine-tryptophan-ketoglutarate (HTK) and physiological saline solution (PSS).
Vessels stored for 4 days in the new solution were significantly better protected than those stored in traditional HTK or PSS. The protective effects comprised: (1) vessel tone development after stimulation with potassium-chloride solution, (2) endothelium-dependent and -independent vessel relaxation, and (3) eNOS expression. With iron chelators (deferoxamine 100 microM, LK 614 20 microM) present in the storage solution, endothelium-dependent relaxations (eNOS-dependent and K(Ca)-channel-dependent) were fully maintained after 96 hours of cold storage. Endothelial cell structure was significantly better maintained after 96 hours in the new solution than in HTK or PSS solutions. Already, 2 hours of cold storage in HTK resulted in a significant loss of structurally intact endothelium. The structural changes correlated significantly with the diminished vessel relaxation capacity. Furthermore, tissue reductive capacity was only preserved after 96 hours storage if the new solution was used.
The new storage solution is superior to traditional HTK and PSS cold storage with respect to: (1) preservation of vessel structure and function; (2) the presence of iron chelators significantly improved protection of endothelial function; and (3) the new solution permits cold vessel storage for a minimum of 4 days with full maintenance of endothelial function and its coupling to smooth muscle.
用于重建和搭桥手术的动脉冷藏可能会导致内皮细胞损伤，进而可能促进低灌注和移植物血管病变。
研究了一种最近开发的、用N-乙酰组氨酸缓冲、富含氯化钾并强化了氨基酸的血管保存溶液，该溶液添加了铁螯合剂去铁胺（100微摩尔/升）和LK 614（20微摩尔/升），对大鼠肠系膜上动脉和主动脉进行研究，涉及以下方面：（1）钾诱导的血管张力；（2）内皮依赖性和非内皮依赖性舒张；（3）在4天冷藏（4摄氏度）期间内皮型一氧化氮合酶（eNOS）蛋白表达。将该溶液与传统保存溶液组氨酸-色氨酸-酮戊二酸（HTK）和生理盐水溶液（PSS）进行比较。
在新溶液中保存4天的血管比在传统HTK或PSS中保存的血管得到了显著更好的保护。保护作用包括：（1）用氯化钾溶液刺激后的血管张力发展；（2）内皮依赖性和非内皮依赖性血管舒张；（3）eNOS表达。由于保存溶液中存在铁螯合剂（去铁胺100微摩尔/升，LK 614 20微摩尔/升），冷藏96小时后内皮依赖性舒张（eNOS依赖性和钾通道依赖性）得以完全维持。在新溶液中冷藏96小时后，内皮细胞结构比在HTK或PSS溶液中得到了显著更好的维持。在HTK中冷藏2小时就导致结构完整的内皮细胞显著丢失。结构变化与血管舒张能力减弱显著相关。此外，只有使用新溶液时，组织还原能力在保存96小时后才得以保留。
新的保存溶液在以下方面优于传统的HTK和PSS冷藏：（1）血管结构和功能的保存；（2）铁螯合剂的存在显著改善了对内皮功能的保护；（3）新溶液允许血管冷藏至少4天，同时内皮功能及其与平滑肌的耦合得以完全维持。
