Budziński G, Suszka-Świtek A, Dec R, Caban A, Wystrychowski W, Oczkowicz G, Heitzman M, Dolińska B, Ryszka F, Cierpka L
Department of General, Vascular and Transplant Surgery, Medical University of Silesia, Katowice, Poland.
Transplant Proc. 2011 Oct;43(8):2895-6. doi: 10.1016/j.transproceed.2011.08.063.
Hepatic ischemia-reperfusion injury remains a significant factor influencing early liver graft function. The aim of this study was to assess the impact on hepatic ischemia as reflected by catecholamine concentrations of different methods of organ preservation.
Catecholamine levels were measured in 24 (n=6/group) pig livers, which underwent 30-minute warm ischemia followed by 30-minute perfusion and subsequent cold storage for 12 hours. For perfusion and preservation, we used University of Wisconsin (UW), histidine-tryptophan-ketoglutarate (HTK), HTK-modified with prolactin (PRL) or Ringer's solutions. Dopamine (DO) and adrenaline (ADR) concentrations in liver venous effluents were assayed using a radioimmunological method after 30 minutes of perfusion and following 12 hours of preservation.
DO and ADR levels were higher after 12 hours preservation compared to 30 minutes of perfusion. HTK produced an increase of over 100%. Addition of PRL (20 IU/L) did not affect DO and ADR levels after 30 minutes of perfusion, but significantly decreased their concentrations at 12 hours of preservation. After UW perfusion and preservation, we observed a 10% increase in catecholamine levels as compared with postperfusion values. Preservation with Ringer's solution demonstrated significantly higher DO and ADR levels compared with other solutions.
Catecholamines are present in the liver after 30 minute of perfusion and 12 hours of cold storage. The increased levels after 12 hours of preservation may be due to their release from intracellular spaces (as a controlled process or as a result of necrosis). It may play a crucial role in reperfusion injury, which, in turn, may explain the mechanism of no-reflow phenomenon.
肝缺血再灌注损伤仍然是影响早期肝移植功能的一个重要因素。本研究的目的是评估不同器官保存方法通过儿茶酚胺浓度反映出的对肝缺血的影响。
对24个猪肝(n = 6/组)进行儿茶酚胺水平测定,这些猪肝经历30分钟的热缺血,随后进行30分钟灌注,接着冷藏12小时。对于灌注和保存,我们使用威斯康星大学(UW)溶液、组氨酸 - 色氨酸 - 酮戊二酸(HTK)溶液、用催乳素(PRL)改良的HTK溶液或林格氏液。在灌注30分钟后以及保存12小时后,采用放射免疫法测定肝静脉流出液中的多巴胺(DO)和肾上腺素(ADR)浓度。
与灌注30分钟后相比,保存12小时后DO和ADR水平更高。HTK使儿茶酚胺水平增加超过100%。添加PRL(20 IU/L)在灌注30分钟后不影响DO和ADR水平,但在保存12小时时显著降低了它们的浓度。与灌注后的值相比,UW灌注和保存后儿茶酚胺水平增加了10%。与其他溶液相比,用林格氏液保存显示出显著更高的DO和ADR水平。
灌注30分钟和冷藏12小时后肝脏中存在儿茶酚胺。保存12小时后水平升高可能是由于它们从细胞内空间释放(作为一个可控过程或坏死的结果)。它可能在再灌注损伤中起关键作用,进而可能解释无复流现象的机制。