Department of Surgery, The University of Melbourne, Austin Health, Studley Road, Heidelberg, Victoria, Australia.
HPB (Oxford). 2012 Feb;14(2):103-14. doi: 10.1111/j.1477-2574.2011.00410.x. Epub 2011 Nov 13.
Approaches to increase organ availability for orthotopic liver transplantation (OLT) often result in the procurement of marginal livers that are more susceptible to ischaemia, preservation and reperfusion injury (IPRI).
The effects of post-OLT hyperbaric oxygen (HBO) therapy on IPRI in a syngeneic rat OLT model were examined at various time-points. The effects of IPRI and HBO on hepatocyte necrosis, apoptosis, proliferation, and sinusoidal morphology and ultrastructure were assessed.
Post-OLT HBO therapy significantly reduced the severity of IPRI; both apoptosis [at 12 h: 6.4 ± 0.4% in controls vs. 1.6 ± 0.7% in the HBO treatment group (p < 0.001); at 48 h: 2.4 ± 0.2% in controls vs. 0.4 ± 0.1% in the HBO treatment group (p < 0.001)] and necrosis [at 12 h: 18.7 ± 1.8% in controls vs. 2.4 ± 0.4% in the HBO treatment group (p < 0.001); at 48 h: 8.5 ± 1.3% in controls vs. 3.4 ± 0.9% in the HBO treatment group (P= 0.019)] were decreased. Serum alanine transaminase was reduced [at 12 h: 1068 ± 920 IU/l in controls vs. 370 ± 63 IU/l in the HBO treatment group (P= 0.030); at 48 h: 573 ± 261 IU/l in controls vs. 160 ± 10 IU/l in the HBO treatment group (P= 0.029)]. Treatment with HBO also promoted liver regeneration [proliferation at 12 h: 4.5 ± 0.1% in controls vs. 1.0 ± 0.3% in the HBO treatment group (p < 0.001); at 48 h: 8.6 ± 0.7% in controls vs. 2.9 ± 0.2% in the HBO treatment group (p < 0.01)] and improved sinusoidal diameter and microvascular density index.
Hyperbaric oxygen therapy has persistent positive effects post-OLT that may potentially transfer into clinical practice.
为增加用于原位肝移植 (OLT) 的供体器官，常需获取边缘供肝，这些供肝更易发生缺血、保存和再灌注损伤 (IPRI)。
本研究在同种异体大鼠 OLT 模型中，检测 OLT 后高压氧 (HBO) 治疗对 IPRI 的影响，并在不同时间点进行评估。检测 IPRI 和 HBO 对肝细胞坏死、凋亡、增殖以及窦状隙形态和超微结构的影响。
OLT 后 HBO 治疗可显著减轻 IPRI 严重程度；凋亡[12 h：对照组为 6.4±0.4%，HBO 治疗组为 1.6±0.7%（p<0.001）；48 h：对照组为 2.4±0.2%，HBO 治疗组为 0.4±0.1%（p<0.001）]和坏死[12 h：对照组为 18.7±1.8%，HBO 治疗组为 2.4±0.4%（p<0.001）；48 h：对照组为 8.5±1.3%，HBO 治疗组为 3.4±0.9%（P=0.019）]均减少。血清丙氨酸转氨酶降低[12 h：对照组为 1068±920 IU/l，HBO 治疗组为 370±63 IU/l（p=0.030）；48 h：对照组为 573±261 IU/l，HBO 治疗组为 160±10 IU/l（p=0.029）]。HBO 治疗还促进肝再生[12 h：对照组为 4.5±0.1%，HBO 治疗组为 1.0±0.3%（p<0.001）；48 h：对照组为 8.6±0.7%，HBO 治疗组为 2.9±0.2%（p<0.01）]，改善窦状隙直径和微血管密度指数。
OLT 后 HBO 治疗具有持续的积极作用，可能转化为临床实践。
