Maessen J G, van der Vusse G J, Vork M, Coumans W A, Kootstra G
Department of Surgery, University Hospital, University of Limburg, Maastricht, The Netherlands.
Transplantation. 1988 Jan;45(1):147-52. doi: 10.1097/00007890-198801000-00032.
To assess the warm ischemia time of kidneys with obscure donor histories we attempted to develop an index for the duration of ischemia by analysis of adenine nucleotides and their degradation products in cortical biopsies of canine kidneys. Two biopsy harvesting techniques were compared. The use of a laboratory technique (dentist's drill) resulted in higher concentrations of adenosine triphosphate (ATP) in normoxic tissue specimens as compared with a clinical method of harvesting biopsies (wedge biopsy). However the sum of adenine nucleotides (AN) (ATP, adenosine diphosphate [ADP], and adenosine monophosphate [AMP]) was not significantly different in both groups (P less than 0.05). Therefore, wedge biopsies were used to study the degradation of AN following 0, 30, 60, 90, and 120 min of ischemia. Adenine nucleotides and their degradation products were assayed by high-performance liquid chromatography. Concentrations of individual adenine nucleotides did not show a consistent correlation with warm ischemia time. However, as the sum of the AN and the sum of their degradation products (DP) decreased and increased, respectively, the balance between these metabolites offered a good correlation with duration of warm ischemia. The ratio of DP to AN was significantly different at each interval (P less than 0.05). To study the influence of temperature on the degradation process, ischemia was induced at 37 degrees C and 32 degrees C. Lowering of the temperature reduced the catabolic rate of the AN. The ratio of DP to AN was significantly different from corresponding values at 37 degrees C. In biopsies of nonischemic human donor kidneys, concentrations of adenine nucleotides and their degradation products were measured. Biopsies weighing less than 0.01% of total renal mass were large enough to meet analytical demands. The ratio of DP to AN in human kidney biopsies was in the same range as in the corresponding dog kidney biopsies. These findings demonstrate that the ratio of DP to AN, as determined from concentrations of purine metabolites in canine cortical wedge biopsies, is a sensitive and potentially useful index of warm ischemia time.
为评估供体病史不明的肾脏的热缺血时间，我们试图通过分析犬肾皮质活检组织中的腺嘌呤核苷酸及其降解产物来制定一个缺血持续时间的指标。比较了两种活检采集技术。与临床活检采集方法（楔形活检）相比，使用实验室技术（牙科钻）导致常氧组织标本中三磷酸腺苷（ATP）浓度更高。然而，两组腺嘌呤核苷酸（AN）（ATP、二磷酸腺苷[ADP]和一磷酸腺苷[AMP]）的总和无显著差异（P<0.05）。因此，采用楔形活检来研究缺血0、30、60、90和120分钟后AN的降解情况。通过高效液相色谱法测定腺嘌呤核苷酸及其降解产物。单个腺嘌呤核苷酸的浓度与热缺血时间没有一致的相关性。然而，随着AN总和及其降解产物（DP）总和分别降低和升高，这些代谢物之间的平衡与热缺血持续时间具有良好的相关性。每个时间间隔DP与AN的比值均有显著差异（P<0.05）。为研究温度对降解过程的影响，分别在37℃和32℃诱导缺血。温度降低会降低AN的分解代谢速率。DP与AN的比值与37℃时的相应值有显著差异。在非缺血性人类供体肾脏的活检组织中，测量了腺嘌呤核苷酸及其降解产物的浓度。重量小于总肾质量0.01%的活检组织足以满足分析需求。人类肾脏活检组织中DP与AN的比值与相应犬肾活检组织中的比值在同一范围内。这些发现表明，根据犬肾皮质楔形活检组织中嘌呤代谢物浓度确定的DP与AN的比值是热缺血时间的一个敏感且可能有用的指标。
