Sasajima Hideaki, Miyagi Shigehito, Yamada Shuhei, Kakizaki Yuta, Kamei Takashi, Unno Michiaki, Goto Masafumi
Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
Transplant Proc. 2020 Jul-Aug;52(6):1891-1900. doi: 10.1016/j.transproceed.2020.01.165. Epub 2020 May 7.
Liver transplantation from donors after cardiac death (DCDs) can increase the pool of available organs. Recently, mesenchymal stem cells (MSCs) have been used to treat various diseases. Some studies have reported that MSCs improve the outcome of liver transplantation from DCDs in mice. The aim of this study was to evaluate the cytoprotective effects and safety of MSC transplantation on liver grafts from DCDs in swine.
For the MSCs, we used swine adipose-derived stem cells (ADSCs). Landrace swine were divided into 3 groups (n = 5) as follows: 1. the heart-beating (HB) group, from which liver grafts were retrieved and transplanted; 2. the DCD group, from which liver grafts were retrieved 10 minutes after apnea-induced cardiac arrest and transplanted; and 3. the ADSC group, from which liver grafts were retrieved as with the DCD group, transplanted, and then infused with 1.0 × 10 ADSCs 2 hours after reperfusion.
In the HB group, all 5 recipients survived for >7 days, whereas all 5 recipients in the DCD group died within 24 hours after transplantation. In the ADSC group, 3 recipients survived for >7 days, whereas 2 recipients died within 4 days after transplantation. The survival rate was significantly higher in the ADSC group than 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.
心脏死亡后供体肝脏移植（DCD）可增加可用器官库。近年来，间充质干细胞（MSC）已被用于治疗多种疾病。一些研究报道，MSC可改善小鼠DCD肝脏移植的结局。本研究旨在评估MSC移植对猪DCD肝脏移植物的细胞保护作用及安全性。
对于MSC，我们使用猪脂肪来源干细胞（ADSC）。长白猪分为3组（n = 5），如下：1. 心跳（HB）组，从中获取肝脏移植物并进行移植；2. DCD组，在呼吸暂停诱导的心脏骤停后10分钟获取肝脏移植物并进行移植；3. ADSC组，与DCD组一样获取肝脏移植物，进行移植，然后在再灌注2小时后注入1.0×10的ADSC。
HB组的所有5只受体均存活超过7天，而DCD组的所有5只受体在移植后24小时内死亡。ADSC组中，3只受体存活超过7天，2只受体在移植后4天内死亡。ADSC组的存活率显著高于DCD组。
MSC可保护肝脏移植物免受热缺血-再灌注损伤，提高DCD肝脏移植物的存活率。
