Furukori M, Matsuno N, Meng L T, Shonaka T, Nishikawa Y, Imai K, Obara H, Furukawa H
Department of Surgery, Asahikawa Medical University, Asahikawa, Japan.
Department of Surgery, Asahikawa Medical University, Asahikawa, Japan.
Transplant Proc. 2016 May;48(4):1239-43. doi: 10.1016/j.transproceed.2015.12.076.
The use of grafts from donors after cardiac death (DCD) would greatly contribute to the expansion of the donor organ pool. However, the implementation of such a strategy requires the development of novel preservation methods to recover from changes owing to warm ischemia. The aim of this study was to evaluate the effectiveness of subnormothermic machine perfusion (MP) preservation with rewarming for porcine DCD liver grafts for transplantation.
Porcine livers were perfused with newly developed MP system. The livers were perfused for 4 hours with modified University of Wisconsin gluconate solution. Group 1 grafts were preserved with no warm ischemia time (WIT) and hypothermic MP (HMP) for 4 hours. Group 2 grafts were preserved with WIT 60 minutes and HMP for 4 hours. Group 3 grafts were preserved with WIT 60 minutes and rewarming up to 25°C by MP (RMP) for 4 hours.
The aspartate aminotransferase and lactate dehydrogenase in the effluent maintained at lower level in group 3 compared with group 2. However, tissue ATP levels did not recover in groups 2 and 3. Histologically, the fatty degenerate and swelling of the hepatocyte was slightly seen in all groups. The normal structure of the hepatocellular cords, the bile duct and the sinusoid endothelium were preserved in all groups.
Potentially, subnormothermic preservation with rewarming is expected to help the recovery of function for DCD liver grafts.
使用心脏死亡（DCD）供体的移植物将极大地有助于扩大供体器官库。然而，实施这样的策略需要开发新的保存方法，以从热缺血引起的变化中恢复。本研究的目的是评估亚低温机器灌注（MP）联合复温保存对猪DCD肝移植移植物的有效性。
用新开发的MP系统灌注猪肝脏。用改良的威斯康星大学葡萄糖酸盐溶液灌注肝脏4小时。第1组移植物在无热缺血时间（WIT）和低温MP（HMP）条件下保存4小时。第2组移植物在WIT 60分钟和HMP条件下保存4小时。第3组移植物在WIT 60分钟并通过MP复温至25°C（RMP）的条件下保存4小时。
与第2组相比，第3组流出液中的天冬氨酸转氨酶和乳酸脱氢酶维持在较低水平。然而，第2组和第3组的组织ATP水平未恢复。组织学上，所有组均可见肝细胞轻微脂肪变性和肿胀。所有组肝细胞索、胆管和窦状内皮的正常结构均得以保留。
潜在地，亚低温复温保存有望帮助DCD肝移植移植物恢复功能。
