Department of Hepato-Pancreato-Biliary Surgery, University Hospitals of Leicester, Leicester, LE5 4PW, United Kingdom.
Department of Hepato-Pancreato-Biliary Surgery, University Hospitals of Leicester, Leicester, LE5 4PW, United Kingdom.
Int J Surg. 2018 Jun;54(Pt A):206-215. doi: 10.1016/j.ijsu.2018.04.057. Epub 2018 May 4.
An ex vivo normothermic porcine pancreas perfusion (ENPPP) model was established to investigate effects of machine perfusion pressures on graft preservation.
Nine porcine pancreata were perfused with autologous blood at 50 mmHg (control) pressure. Graft viability was compared against four ex-vivo porcine pancreata perfused at 20 mmHg ('low') pressure. Arterio-venous oxygen gas differentials, biochemistry, and graft insulin responses to glucose stimulation were compared. Immunohistochemistry stains compared the cellular viability.
Control pancreata were perfused for a median of 3 h (range 2-4 h) with a mean pressure 50 mmHg and graft flow 141 mL min. In comparison, all of the 'low' pressure models were perfused for 4 h, with mean perfusion pressure 20 mmHg and graft flow 40 mL.min-1. All pancreata demonstrated cellular viability with evidence of oxygen consumption with preserved endocrine and exocrine function. However, following statistical analysis, the 'low' pressure perfusion of porcine pancreata compared favourably in important biochemical and immunohistochemistry cellular profiles; potentially arguing for an improved method for graft preservation.
ENPPP will facilitate whole organ preservation to be studied in further detail and avoids use of expensive live animals. ENPPP is reproducible and mimics a "donation after circulatory death" scenario.
建立了一种猪离体胰腺常温灌流（ENPPP）模型，以研究机器灌注压力对移植物保存的影响。
用自体血液以 50mmHg（对照）压力灌注 9 个猪胰腺。将离体猪胰腺 4 个在 20mmHg（“低”）压力下灌注，与 9 个对照胰腺的供体活力进行比较。比较动静脉血氧分压差、生化指标和移植体对葡萄糖刺激的胰岛素反应。免疫组织化学染色比较细胞活力。
对照胰腺以 50mmHg 的平均压力和 141ml/min 的移植体流量灌注中位数为 3h（范围 2-4h）。相比之下，所有“低”压模型的灌注时间均为 4h，平均灌注压力为 20mmHg，移植体流量为 40ml/min。所有胰腺均显示出细胞活力，表明有氧气消耗，具有保存的内分泌和外分泌功能。然而，经过统计学分析，猪胰腺的“低”压灌注在重要的生化和免疫组织化学细胞特征方面表现良好；这可能为移植体保存提供了一种更好的方法。
ENPPP 将有助于更详细地研究整个器官的保存，并且避免使用昂贵的活体动物。ENPPP 是可重复的，模拟了“心脏死亡后捐献”的情况。
