Department for General, Visceral, and Transplantation Surgery, University Hospital of Essen, Germany.
J Surg Res. 2011 Dec;171(2):859-64. doi: 10.1016/j.jss.2010.06.009. Epub 2010 Jun 30.
The benefit of carbon monoxide and/or oxygen as applied by controlled, continuous gaseous persufflation during liver preservation on postischemic graft recovery was investigated in an isolated rat liver model.
Livers from male Wistar rats were retrieved 30 min after cardiac arrest of the donor and subjected to 18 h of cold storage. Some grafts were subjected to gaseous persufflation during static cold storage either with pure oxygen or with CO dissolved in oxygen. Graft integrity was assessed thereafter upon warm reperfusion in vitro.
Oxygen persufflation significantly reduced cellular enzyme loss and metabolic recovery (bile production and ATP recovery) upon reperfusion by about 50%. The effect was associated with a reduction of vascular perfusion resistance, mitigated gene up-regulation of the mitochondrial stress protein GRP 75, and improved mitochondrial ultra-structure. Similar results were obtained by persufflation with CO in oxygen, while no additive benefit of CO and oxygen could be seen in our model.
Hepatocellular injury of cold stored liver grafts can be notably reduced by gaseous ex vivo application of oxygen with or without additional admixture of CO to the isolated organ but no superiority or additive effect is seen with respect to persufflation with oxygen.
在离体大鼠肝脏模型中，研究了在肝保存过程中应用一氧化碳和/或氧气进行控制性、连续气体吹入对缺血后移植物恢复的益处。
在供体心脏骤停 30 分钟后，从雄性 Wistar 大鼠中取出肝脏，并进行 18 小时的冷藏。一些移植物在静态冷藏期间进行气体吹入，分别使用纯氧或溶解在氧气中的 CO。此后，在体外温热再灌注后评估移植物的完整性。
氧气吹入显著降低了再灌注时细胞酶的损失和代谢恢复（胆汁生成和 ATP 恢复），降低了约 50%。这种效果与血管灌注阻力的降低、线粒体应激蛋白 GRP 75 的基因上调减轻以及线粒体超微结构的改善有关。用氧气中的 CO 吹入也得到了类似的结果，而在我们的模型中，CO 和氧气的联合吹入并没有显示出额外的益处。
用氧气或氧气中添加 CO 进行离体器官的体外应用，可以显著减少冷藏肝移植物的肝细胞损伤，但在氧气吹入方面没有优势或增效作用。
