Department of Anesthesiology, Penn State Milton S. Hershey Medical Center, Pennsylvania State University College of Medicine, Hershey, Pennsylvania 17033-0850, USA.
J Surg Res. 2012 Jun 1;175(1):131-7. doi: 10.1016/j.jss.2011.02.046. Epub 2011 Apr 9.
Cold storage in any of the commonly used preservation solutions is not always adequate for donation after cardiac death (DCD) liver grafts due to prolonged warm ischemic time. In this study, we used a third-generation perfluorocarbon (PFC), Oxycyte, for DCD liver graft preservation in a rat model.
Twenty-eight rats (14 in each group) were used. Thirty minutes after cardiopulmonary arrest, livers were harvested and flushed with a cold and pre-oxygenated solution of either University of Wisconsin (UW) or UW + 20% PFC. After 8 h of cold preservation in either of the investigated solutions, liver graft specimens were analyzed for evidence of ischemic injury. Hemotoxylin and eosin staining (H and E), as well as immunohistochemical analysis with anti-cleaved caspase 3 antibody, was performed. Levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the preservation solution were analyzed at 1 and 8 h during preservation.
In the PFC group, the degree of cell congestion, vacuolization and necrosis were all significantly less than in the UW group (P = 0.002-0.004). The number of cells with a positive cleaved caspase 3 antibody reaction was reduced by about 50% in comparison with the UW group (P < 0.006). The AST level in the PFC group was significantly less than in the UW group after 8 h of preservation (P < 0.048).
The addition of PFC to UW solution significantly decreases the degree of histologic damage in rat DCD liver grafts. This preservation strategy can be potentially helpful for organ preservation after prolonged warm ischemia.
由于热缺血时间延长，在任何常用保存液中冷藏都不能为心脏死亡后供体（DCD）的肝脏移植提供充分的保障。在这项研究中，我们使用第三代全氟化碳（PFC）Oxycyte 为大鼠模型中的 DCD 肝脏移植物保存。
使用 28 只大鼠（每组 14 只）。心肺骤停 30 分钟后，收获肝脏并使用冷预充氧的 UW 或 UW+20% PFC 溶液冲洗。在这两种研究溶液中冷藏 8 小时后，分析肝移植物标本以确定是否存在缺血性损伤。进行苏木精和伊红染色（H 和 E）以及用抗 cleaved caspase 3 抗体进行免疫组织化学分析。在保存过程中于 1 小时和 8 小时分析保存液中丙氨酸转氨酶（ALT）和天冬氨酸转氨酶（AST）的水平。
在 PFC 组中，细胞充血、空泡化和坏死的程度均明显低于 UW 组（P=0.002-0.004）。与 UW 组相比，cleaved caspase 3 抗体反应阳性的细胞数量减少了约 50%（P<0.006）。与 UW 组相比，在 8 小时的保存后，PFC 组中的 AST 水平明显降低（P<0.048）。
在 UW 溶液中添加 PFC 可显著降低大鼠 DCD 肝移植物的组织损伤程度。这种保存策略可能有助于延长热缺血后的器官保存。
