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移植前实体器官的实验性分离与保存:四种不同分子预处理的效果

Experimental isolation and preservation of solid organs before transplantation: effects of pretreatment using four different molecules.

作者信息

Chalasti Maria, Iordanou Christos, Kratiras Zisis, Stylianaki Aikaterini, Trigka Eleni-Andriana, Lakiotaki Eleftheria, Makedou Kali, Iliadis Stavros, Zografos Konstantinos G, Dimitroulis Dimitrios, Chrisofos Michail, Patsouris Efstratios, Zografos Georgios C, Bouboulis George C, Papalois Apostolos E

机构信息

Experimental, Educational and Research Centre, ELPEN, Pikermi, Athens, Greece.

First Department of Propaedeutic Surgery, University of Athens, School of Medicine, Hippocration Hospital, Athens, Greece.

出版信息

J Int Med Res. 2020 Jun;48(6):300060520933452. doi: 10.1177/0300060520933452.

Abstract

OBJECTIVES

In transplantation surgery, the ischaemic organ and reperfusion impairment after cold storage remains a considerable risk factor for impaired function and potential failure of the grafted organ. Substantial logistical efforts have been undertaken to reduce the cold ischaemic time because the demand for available transplant organs and the periods of cold ischaemia are increasing.

METHODS

Four molecules were investigated (erythropoietin, sildenafil, lazaroid [U74389G], octreotide) in individual intravenous infusions 1 hour before the organ was harvested. This study was performed in 30 healthy landrace/large-white pigs (male; >10 weeks old; average weight, 22 ± 2 kg) in groups of six. The organs were studied at harvest, and at 8 and 24 hours post-harvest.

RESULTS

The lazaroid molecule increased malondialdehyde (MDA) levels in the liver and pancreas at 8 hours. Hepatic lazaroid molecules improved liver histology at 8 and 24 hours. For kidneys, erythropoietin had a positive effect at 24 hours post-harvest. For the pancreas, octreotide showed better performance. In the lungs, there was less interstitial oedema with erythropoietin and lazaroid compared with the control group at 8 hours post-harvest.

CONCLUSION

All molecules had a positive effect and decreased ischaemia/reperfusion graft injury. Thus, pretreatment before organ harvest has a beneficial role.

摘要

目的

在移植手术中,冷藏后的缺血器官和再灌注损伤仍然是移植器官功能受损和潜在衰竭的一个相当大的风险因素。由于可用移植器官的需求和冷缺血时间在增加,已经做出了大量后勤努力来减少冷缺血时间。

方法

在器官收获前1小时,对四种分子(促红细胞生成素、西地那非、拉扎罗类药物[U74389G]、奥曲肽)进行单独静脉输注研究。本研究在30头健康的长白猪/大白猪(雄性;>10周龄;平均体重,22±2千克)中进行,每组6头。在收获时以及收获后8小时和24小时对器官进行研究。

结果

拉扎罗类药物分子在8小时时增加了肝脏和胰腺中的丙二醛(MDA)水平。肝脏中的拉扎罗类药物分子在8小时和24小时时改善了肝脏组织学。对于肾脏,促红细胞生成素在收获后24小时有积极作用。对于胰腺,奥曲肽表现更好。在肺中,与对照组相比,收获后8小时时促红细胞生成素和拉扎罗类药物导致的间质水肿更少。

结论

所有分子都有积极作用,并减少了缺血/再灌注移植损伤。因此,器官收获前的预处理具有有益作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eedc/7328361/045e7adf3e91/10.1177_0300060520933452-fig1.jpg

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