Division of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan.
PLoS One. 2012;7(8):e42319. doi: 10.1371/journal.pone.0042319. Epub 2012 Aug 10.
Several studies have reported that pancreatic ductal preservation greatly improved the islet yield and function after cold storage. However, these studies were devoid of appropriate controls, such as vascular perfusion, which is routinely performed to preserve organs in the clinical setting. In this study, we created a vascular perfusion model using inbred rats, and investigated the effect of ductal injection on the islet yield and function after cold storage. Rat pancreases after 10 h cold ischemia were classified as follows: without ductal/vascular perfusion; with ductal injection; with vascular perfusion; and with ductal/vascular perfusion. The islet yield, function, viability, release of inflammatory mediators, and pathological changes in the exocrine tissues were assessed in the Hanks' Balanced Salt Solution (HBSS) model. The islet yield was also assesed by introducing University of Wisconsin Solution (UWS) and Histidine-Tryptophan-Ketoglutarate solution (HTK), which are the standard clinical preservation solutions. In the HBSS model, ductal injection and vascular perfusion significantly improved the islet yield compared with the control group. However, ductal injection showed no additional effects on the islet yield, function, viability and suppressing the release of inflammatory mediators when vascular perfusion was performed. Although ductal injection significantly decreased the apoptosis of exocrine cells, no beneficial effect on vacuolation was observed. In contrast, vascular perfusion significantly suppressed vacuolation in the exocrine tissues. Likewise, in the UWS and HTK model, ductal injection and vascular perfusion improved the islet yield compared with the control group. Nevertheless, the combination group showed no additional effects. These data suggest that ductal injection has no additional effect on islet yield and function after cold storage in a vascular perfusion model. We propose that ductal injection can be an effective and simple alternative for vascular perfusion prior to pancreas harvest, but is not necessary in most cases, since vascular perfusion is routinely performed.
多项研究报道,在冷保存后,保留胰管可显著提高胰岛的产量和功能。然而,这些研究缺乏适当的对照,例如血管灌注,这是临床常规用于保存器官的方法。在这项研究中,我们使用近交系大鼠创建了一个血管灌注模型,并研究了在冷保存后胰管注射对胰岛产量和功能的影响。经过 10 小时冷缺血的大鼠胰腺分为以下几组:无胰管/血管灌注组;胰管注射组;血管灌注组;胰管/血管灌注组。在 Hank's 平衡盐溶液(HBSS)模型中评估胰岛的产量、功能、活力、炎症介质的释放以及外分泌组织的病理变化。还通过引入威斯康星大学溶液(UWS)和组氨酸-色氨酸-酮戊二酸溶液(HTK)评估胰岛的产量,这是标准的临床保存溶液。在 HBSS 模型中,与对照组相比,胰管注射和血管灌注显著提高了胰岛的产量。然而,当进行血管灌注时,胰管注射对胰岛的产量、功能、活力和抑制炎症介质的释放没有额外的作用。虽然胰管注射显著减少了外分泌细胞的凋亡,但对外分泌细胞空泡化没有观察到有益的作用。相比之下,血管灌注显著抑制了外分泌组织的空泡化。同样,在 UWS 和 HTK 模型中,与对照组相比,胰管注射和血管灌注提高了胰岛的产量。然而,联合组没有显示出额外的效果。这些数据表明,在血管灌注模型中,胰管注射对冷保存后的胰岛产量和功能没有额外的作用。我们提出,在胰腺采集前,胰管注射可以作为血管灌注的有效且简单的替代方法,但在大多数情况下不需要,因为血管灌注是常规进行的。