Sereinigg M, Puntschart A, Seifert-Held T, Zmugg G, Wiederstein-Grasser I, Marte W, Marko T, Tscheliessnigg K H, Stadlbauer V, Stiegler P
Department of Transplantation Surgery, Medical University Graz, Graz, Austria.
Transplant Proc. 2012 Sep;44(7):2193-6. doi: 10.1016/j.transproceed.2012.07.104.
Due to the lack of human donors, several strategies have sought to expand the organ pool. Efforts to characterize donation after cardiac death (DCD) have included studies of cell viability, histological and immunohistochemical changes, and oxidative stress, which is known to negatively impact graft survival. A large animal model would be useful for these inquiries. Therefore, we sought to establish a DCD animal model in pigs.
We simulated non-heart-beating donation Maastricht II and III conditions in 24 pigs. Cardiac fibrillation was induced using 9-V direct current. After various times of ventricular fibrillation (1-10 minutes) with no mechanical and/or medical treatment to achieve cardiac output, reanimation was performed for 30 minutes prior to multiorgan donation. Then, a neurological status was performed. Blood samples were obtained at defined times tissue samples were stored in liquid nitrogen and subsequently embedded in paraffin and subjected to further analysis.
We established a DCD pig model in our laboratory by inducing cardiac fibrillation. Up to now, only DCD donation according to the Maastricht criteria II and III has been performed, but establishing all Maastricht criteria of DCDs seems to be feasible.
A DCD model in pigs enables us to characterize organ quality more precisely as well as evaluate amelioration of storage conditions and donor treatments in a large-animal model.
由于人类供体的短缺，人们尝试了多种策略来扩大器官库。对心脏死亡后捐赠（DCD）进行特征描述的工作包括对细胞活力、组织学和免疫组化变化以及氧化应激的研究，氧化应激已知会对移植物存活产生负面影响。大型动物模型对这些研究很有用。因此，我们试图在猪身上建立DCD动物模型。
我们在24头猪身上模拟了马斯特里赫特II型和III型非心跳捐赠条件。使用9伏直流电诱发心脏颤动。在无机械和/或药物治疗以实现心输出量的情况下，让心室颤动持续不同时间（1 - 10分钟）后，在多器官捐赠前进行30分钟的复苏。然后，进行神经学评估。在特定时间采集血样，组织样本储存在液氮中，随后嵌入石蜡并进行进一步分析。
我们通过诱发心脏颤动在实验室中建立了DCD猪模型。到目前为止，仅按照马斯特里赫特标准II型和III型进行了DCD捐赠，但建立所有DCD的马斯特里赫特标准似乎是可行的。
猪的DCD模型使我们能够更精确地描述器官质量，以及在大型动物模型中评估储存条件和供体处理方法的改善情况。
