Roskott Anne Margot C, van Haaften Wouter T, Leuvenink Henri G D, Ploeg Rutger J, van Goor Harry, Blokzijl Tjasso, Ottens Petra J, Dijkstra Gerard, Nieuwenhuijs Vincent B
Department of Surgery, University Medical Center Groningen, University of Groningen, The Netherlands.
Department of Surgery, University Medical Center Groningen, University of Groningen, The Netherlands.
J Surg Res. 2014 Jun 1;189(1):143-51. doi: 10.1016/j.jss.2014.02.008. Epub 2014 Feb 18.
The Organ Procurement and Transplantation Network (OPTN) has formulated criteria for the selection of donors for intestinal transplantation. To date, however, no study has correlated histologic findings of intestinal injury with the OPTN criteria. We aimed to describe histopathologic and molecular features of allograft injury in relation to donor conditions defined by the OPTN criteria.
Graft histology (Park Score), Claudin-3 staining, systemic inflammatory markers (C-reactive protein/lipopolysaccharide-binding protein) and expression of heat shock protein 70, heme oxygenase 1, and interleukin 6 were evaluated in multiorgan deceased donors (donation after brain death [DBD] and donation after cardiac death [DCD]).
Ninety-seven samples (52 jejunum/45 ileum) were recovered from 59 donors (46 DBD/13 DCD). The OPTN criterion cold ischemia time correlated with histologic injury (Park score) to which the jejunum appeared more susceptible than the ileum. Claudin-3 staining was higher, and heat shock protein 70 expression lower in donors meeting the OPTN criteria compared with donors not meeting the criteria and in DBD versus DCD. In DBD donors, interleukin 6 expression was higher compared with DCD donors and inversely related to C-reactive protein.
Our multiparameter analysis suggests that the OPTN criteria can be discriminative concerning intestinal graft quality. Our data suggest that DCD intestinal allografts are qualitatively inferior and that the jejunum is more sensitive to ischemia than the ileum.
器官获取与移植网络（OPTN）已制定了肠道移植供体选择标准。然而，迄今为止，尚无研究将肠道损伤的组织学表现与OPTN标准相关联。我们旨在描述与OPTN标准所定义的供体状况相关的同种异体移植物损伤的组织病理学和分子特征。
对多器官脑死亡后供体（DBD）和心脏死亡后供体（DCD）的移植物组织学（帕克评分）、紧密连接蛋白3染色、全身炎症标志物（C反应蛋白/脂多糖结合蛋白）以及热休克蛋白70、血红素加氧酶1和白细胞介素6的表达进行了评估。
从59名供体（46名DBD/13名DCD）中获取了97个样本（52个空肠/45个回肠）。OPTN标准中的冷缺血时间与组织学损伤（帕克评分）相关，空肠似乎比回肠更容易受到影响。与未符合标准的供体相比，符合OPTN标准的供体中紧密连接蛋白3染色更高，而热休克蛋白70表达更低，且DBD供体与DCD供体相比也是如此。在DBD供体中，白细胞介素6的表达高于DCD供体，且与C反应蛋白呈负相关。
我们的多参数分析表明，OPTN标准在肠道移植物质量方面具有鉴别性。我们的数据表明，DCD肠道同种异体移植物在质量上较差，且空肠比回肠对缺血更敏感。
