Sumimoto R, Kamada N, Jamieson N V, Fukuda Y, Dohi K
Department of Experimental Surgery, National Children's Medical Research Center, Tokyo, Japan.
Transplantation. 1991 Mar;51(3):589-93. doi: 10.1097/00007890-199103000-00010.
Forty-six rat liver transplants were performed to investigate the effectiveness of a simplified lactobionate solution containing histidine as a buffer (histidine-lactobionate solution) and to compare it with University of Wisconsin solution. This new solution is isoosmotic (320 mOsm/L) and has a higher sodium content and a lower potassium content (Na: 90 mEq/L, K: 45 mEq/L) than standard UW solution. Buffering capacity is increased by adding histidine (90 mM/L) together with KH2PO4 (20 mM/L) and is greater than that of Eurocollins solution or UW solution. Adenosine, insulin, hydroxyethyl starch, and dexamethasone that are included in UW solution are not included in the new solution. The 1-week survival rate of rats transplanted with livers preserved in this solutions at 4 degrees C was 85% (11/13) following 24-hr preservation and 33% (2/6) after 30-hr preservation. By contrast, UW solution gave only a 29% (5/17) survival rate after 24-hr preservation and 0% (0/6) survival after 30-hr preservation, demonstrating that this simplified UW solution with histidine is superior to UW solution in rat liver preservation. No rats (0/4) receiving livers preserved for 24 hr in Eurocollins solution survived. These findings show that the inclusion of histidine as a buffer dramatically improves the effectiveness of lactobionate-based preservation solutions and justify application in a large-animal model and subsequently in clinical liver transplantation.
进行了46例大鼠肝移植手术,以研究含有组氨酸作为缓冲剂的简化乳糖酸盐溶液(组氨酸-乳糖酸盐溶液)的有效性,并将其与威斯康星大学溶液进行比较。这种新溶液是等渗的(320 mOsm/L),与标准的UW溶液相比,钠含量更高,钾含量更低(钠:90 mEq/L,钾:45 mEq/L)。通过添加组氨酸(90 mM/L)和磷酸二氢钾(20 mM/L)来提高缓冲能力,其缓冲能力大于欧洲柯林斯溶液或UW溶液。UW溶液中所含的腺苷、胰岛素、羟乙基淀粉和地塞米松在新溶液中未包含。在4℃下用该溶液保存肝脏的大鼠,24小时保存后1周存活率为85%(11/13),30小时保存后为33%(2/6)。相比之下,UW溶液在24小时保存后的存活率仅为29%(5/17),30小时保存后存活率为0%(0/6),表明这种含组氨酸的简化UW溶液在大鼠肝脏保存方面优于UW溶液。接受在欧洲柯林斯溶液中保存24小时肝脏的大鼠无一存活(0/4)。这些发现表明,加入组氨酸作为缓冲剂可显著提高基于乳糖酸盐的保存溶液的有效性,并证明其在大动物模型中以及随后在临床肝移植中的应用是合理的。