Caban A, Dolińska B, Budziński G, Oczkowicz G, Ostróżka-Cieślik A, Cierpka L, Ryszka F
Department of General Vascular and Transplant Surgery, Medical University of Silesia, Sosnowiec, Kasztanowa.
Transplant Proc. 2013 Jun;45(5):1720-2. doi: 10.1016/j.transproceed.2013.01.094.
The aim of our study was to evaluate the impact of perfusion with HTK (histidine-tryptophan-ketoglutarate, Custodiol®, Dr. Franz Kohler Chemie, Germany) solution, modified by the addition of porcine thyroid-stimulating hormone (TSH) and corticotropin (ACTH), on selected biochemical parameters of porcine renal damage within 24 and 48 hours after the onset of cold ischemia time.
Each study group consisted of 10 adult pigs. During harvesting the kidneys were rinsed with Ringer solution (group 1), HTK (group 2), HTK-TSH (1 μg/dL) or HTK-ACTH (1 μg/dL) in groups 3 and 4. The solutions were cooled to 4°C-6°C. Within 30 minutes of the first perfusion, the discharged fluid was clear and the kidneys cooled to 4°C. The levels of lactate dehydrogenase, asparagine and alanine aminotransferases, lactates, total protein, potassium, calcium, and pH were determined in the perfusate. After 24 and 48 hours the rinsing procedure and the above-mentioned tests were repeated. Differences between the means of 2 independent samples were tested with a nonparametric Mann-Whitney U test.
As the result of hormone addition, in both time intervals it was possible to observe considerably lower protein concentrations (g/L) in perfusates compared with HTK solution, without an addition. At 24 hours, we measured following values: 36 ± 4, 8 ± 3 and 6 ± 1 versus 48 hours, 34 ± 1, 2 ± 1, and 4 ± 1 in groups 2, 3, and 4. A similar pattern was observed with LDH (U/L) at 48 hours: 662 ± 89, 374 ± 151, and 386 ± 111, respectively. Lactate concentrations (mmol/L) were then significantly higher: 1.4 ± 0.3 in the TSH group and 1.2 ± 0.5 in the ACTH group as opposed to 0.2 ± 0.1 in unmodified HTK group.
We observed the possibility of cytoprotective actions of TSH and ACTH addition to the perfusion fluid during cold ischemia, positive effects that were especially visible upon prolonged 48-hour storage.
我们研究的目的是评估在冷缺血时间开始后的24小时和48小时内，添加猪促甲状腺激素（TSH）和促肾上腺皮质激素（ACTH）对猪肾损伤选定生化参数的影响，灌注液为组氨酸-色氨酸-酮戊二酸（HTK，Custodiol®，德国弗朗茨·科勒化学博士公司）溶液。
每个研究组由10只成年猪组成。在摘取肾脏时，用林格氏溶液冲洗肾脏（第1组），第2组用HTK冲洗，第3组和第4组分别用HTK-TSH（1μg/dL）或HTK-ACTH（1μg/dL）冲洗。将溶液冷却至4°C-6°C。在首次灌注的30分钟内，排出的液体清澈，肾脏冷却至4°C。测定灌注液中乳酸脱氢酶、天冬酰胺和丙氨酸转氨酶、乳酸、总蛋白、钾、钙和pH值。在24小时和48小时后重复冲洗程序和上述测试。用非参数曼-惠特尼U检验对两个独立样本的均值差异进行检验。
由于添加了激素，在两个时间间隔内，与未添加激素的HTK溶液相比，灌注液中的蛋白质浓度（g/L）明显更低。在24小时时，我们测得第2、3和4组的值分别为：36±4、8±3和6±1，而在48小时时分别为：34±1、2±1和4±1。在48小时时，乳酸脱氢酶（U/L）也观察到类似模式：分别为662±89、374±151和386±111。乳酸浓度（mmol/L）则显著更高：TSH组为1.4±0.3，ACTH组为1.2±0.5，而未改良的HTK组为0.2±0.1。
我们观察到在冷缺血期间向灌注液中添加TSH和ACTH具有细胞保护作用的可能性，这种积极作用在延长至48小时的储存期时尤为明显。
