Foltys Daniel, Kaths Moritz, Strempel Mari, Scheuermann Uwe, Heimann Axel, Weyer Veronika, Hansen Torsten, Kempski Oliver, Otto Gerd
Department of Transplantation and Hepatobiliopancreatic Surgery, University Medical Centre, Johannes Gutenberg University, Langenbeckstraße 1, 55131, Mainz, Germany.
Transplant Res. 2013 Jul 9;2(1):13. doi: 10.1186/2047-1440-2-13.
The first crucial step in transplantation appears to be the effective rinsing of the graft during organ procurement. Even though there is strong suspicion that perfusion results in better rinsing of the graft, there is no proof for this hypothesis. The aim of this study was to analyse the differences of and kidney perfusion in a porcine model.
Standardised multiorgan procurement was performed in 15 German landrace pigs. Perfusion was carried out using histidine–tryptophan–ketoglutarate solution (HTK) under the application of pressure. In one kidney, perfusion via the aorta was carried out while the second kidney received perfusion via the renal artery (RA). Perfusate flow inside the aorta and the RA was recorded at different pressure steps. In order to visualise the effect on the microcirculation, different coloured microparticles (MPs; 10 μm) were administered via the aorta or RA. Subsequently, frozen sections of the explanted kidneys were analysed histologically and MPs were evaluated quantitatively.
kidney perfusion resulted in significantly improved flow rates (<0.0001) compared with perfusion. By applying perfusion it was even possible to attain physiological flow levels on the RA under the application of external pressure of 150 to 200 mmHg. The amount of MPs was able to highlight the positive impact of perfusion on microcirculation of the kidney graft (<0.0001).
The use of MPs represents a valuable tool for quantitative investigation and illustration of kidney perfusion in experimental setups. Additional e perfusion is able to improve the quality of kidney perfusion.
移植的首要关键步骤似乎是在器官获取过程中对移植物进行有效冲洗。尽管人们强烈怀疑灌注能使移植物冲洗得更好，但这一假设尚无证据支持。本研究的目的是分析猪模型中主动脉灌注和肾动脉灌注的差异。
对15头德国长白猪进行标准化多器官获取。在压力作用下使用组氨酸 - 色氨酸 - 酮戊二酸溶液（HTK）进行灌注。在一侧肾脏，通过主动脉进行灌注，而另一侧肾脏通过肾动脉（RA）进行灌注。在不同压力步骤下记录主动脉和肾动脉内的灌注液流量。为了观察对微循环的影响，通过主动脉或肾动脉给予不同颜色的微颗粒（MPs；10μm）。随后，对切除的肾脏进行冷冻切片组织学分析，并对微颗粒进行定量评估。
与肾动脉灌注相比，主动脉灌注导致流速显著提高（<0.0001）。通过应用主动脉灌注，甚至有可能在150至200 mmHg的外部压力下使肾动脉达到生理流量水平。微颗粒的数量能够突出主动脉灌注对肾移植物微循环的积极影响（<0.0001）。
微颗粒的使用是实验装置中对肾脏灌注进行定量研究和说明的有价值工具。额外的主动脉灌注能够提高肾脏灌注质量。
