Sasajima H, Miyagi S, Kakizaki Y, Kamei T, Unno M, Satomi S, Goto M
Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
Transplant Proc. 2018 Nov;50(9):2815-2820. doi: 10.1016/j.transproceed.2018.02.180. Epub 2018 Mar 20.
Liver transplantation from donors after cardiac death (DCD) might increase the pool of available organs. Recently, some investigators reported the potential use of mesenchymal stem cells (MSCs) to improve the outcome of liver transplantation from DCD. The aim of this study was to evaluate the cytoprotective effects and safety of MSC transplantation on liver grafts from DCD.
Rats were divided into 4 groups (n = 5) as follows: 1. the heart-beating group, in which liver grafts were retrieved from heart-beating donors; 2. the DCD group, in which liver grafts were retrieved from DCD that had experienced apnea-induced agonal conditions; 3. the MSC-1 group, and 4. the MSC-2 group, in which liver grafts were retrieved as with the DCD group, but were infused MSCs (2.0 × 10 or 1.0 × 10, respectively). The retrieved livers were perfused with oxygenated Krebs-Henseleit bicarbonate buffer (37°C) through the portal vein for 2 hours after 6 hours of cold preservation. Perfusate, bile, and liver tissues were then investigated.
Bile production in the MSC-2 group was significantly improved compared with that in the DCD group. Based on histologic findings, narrowing of the sinusoidal space in the both MSC groups was improved compared with that in the DCD group.
MSCs could protect the function of liver grafts from warm ischemia-reperfusion injury and improve the viability of DCD liver grafts. In addition, we found that the infusion of 1.0 × 10 MSCs does not obstruct the hepatic sinusoids of grafts from DCD.
心脏死亡后供体肝脏移植(DCD)可能会增加可用器官库。最近,一些研究人员报道了间充质干细胞(MSCs)在改善DCD肝脏移植结局方面的潜在用途。本研究的目的是评估MSCs移植对DCD肝脏移植物的细胞保护作用和安全性。
将大鼠分为4组(每组n = 5):1. 心跳组,从心跳供体获取肝脏移植物;2. DCD组,从经历呼吸暂停诱导濒死状态的DCD供体获取肝脏移植物;3. MSC-1组;4. MSC-2组,与DCD组一样获取肝脏移植物,但分别注入2.0×10或1.0×10的MSCs。在冷保存6小时后,通过门静脉用含氧的Krebs-Henseleit碳酸氢盐缓冲液(37°C)灌注获取的肝脏2小时。然后对灌注液、胆汁和肝脏组织进行研究。
与DCD组相比,MSC-2组的胆汁分泌显著改善。基于组织学发现,与DCD组相比,两个MSC组的肝血窦间隙变窄情况均有所改善。
MSCs可以保护肝脏移植物免受热缺血-再灌注损伤,提高DCD肝脏移植物的活力。此外,我们发现注入1.0×10的MSCs不会阻塞DCD移植物的肝血窦。