Kay M D, Hosgood S A, Bagul A, Nicholson M L
Transplant Group, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK.
Br J Surg. 2009 Oct;96(10):1215-21. doi: 10.1002/bjs.6681.
Viscous preservation solutions such as University of Wisconsin solution (UW) may be less effective at rapid removal of blood from an organ so that cooling takes longer. This study assessed the temperature changes of kidneys flushed with UW and hyperosmolar citrate (HOC).
Porcine kidneys were retrieved and flushed with 500 ml UW or HOC at 4 degrees C while monitoring kidney temperature at depths of 5 and 20 mm. Renal function was measured on an isolated organ preservation system.
The mean(s.d.) rate of temperature fall was slower with UW (at 20 mm: 0.64(0.11) versus 1.01(0.56) degrees C per min per 100 g; P = 0.016). The perfusion flow rate required to reduce the temperature to less than 10 degrees C at a depth of 20 mm was lower in the UW group (P = 0.002). Kidneys flushed with HOC gained more weight than those flushed with UW (mean(s.d.) 50(8) versus 7(13) per cent; P = 0.002). Flushing with UW was associated with less histological injury but there were no significant differences in renal function parameters between the groups.
UW cooled kidneys more slowly than HOC, but with no adverse effect on renal function. UW resulted in less oedema and histological injury than HOC.
粘性保存液,如威斯康星大学溶液(UW),在快速清除器官内血液方面可能效果较差,以至于冷却时间更长。本研究评估了用UW和高渗柠檬酸盐(HOC)冲洗的肾脏的温度变化。
获取猪肾,在4℃下用500ml UW或HOC冲洗,同时监测5mm和20mm深度处的肾脏温度。在离体器官保存系统上测量肾功能。
UW组的平均(标准差)降温速率较慢(在20mm深度处:每分钟每100g为0.64(0.11)℃ 对1.01(0.56)℃;P = 0.016)。在20mm深度处将温度降至10℃以下所需的灌注流速在UW组较低(P = 0.002)。用HOC冲洗的肾脏比用UW冲洗的肾脏重量增加更多(平均(标准差)为50(8)% 对7(13)%;P = 0.002)。用UW冲洗与较少的组织学损伤相关,但两组之间的肾功能参数无显著差异。
UW冷却肾脏的速度比HOC慢,但对肾功能无不良影响。UW导致的水肿和组织学损伤比HOC少。