Iu S, Harvey P R, Makowka L, Petrunka C N, Ilson R G, Strasberg S M
Department of Surgery, Mount Sinai Hospital, Toronto, Canada.
Transplantation. 1987 Oct;44(4):562-9. doi: 10.1097/00007890-198710000-00021.
The relationship between transplant viability and liver function has been examined. Wistar rat livers were preserved at 4 degrees C for increasing intervals and then transplanted into Wistar rat recipients. Two critical times were identified, the longest preservation period with 100% transplantation success (4 hr) and the shortest preservation period with 100% transplant failure (8 hr). The comparable critical times were also identified in livers preserved at 37 degrees C (1 hr and 2 hr). Liver functions were studied by the isolated perfused liver technique in other rat livers stored at 4 degrees C or 37 degrees C for the critical times. Two liver function tests, AST and LDH concentration in perfusate, discriminated between viable and nonviable livers across as well as within preservation groups. AST gave the best separation between viable and nonviable livers. Some functions such as ALT concentration in perfusate separated viable from non viable allografts only within preservation groups. Other liver functions were more sensitive to preservation temperature than allograft viability. Oxygen consumption after cold preservation for either critical time was about twice control levels. Urea production was far below control levels in warm-preserved livers but almost normal in cold-preserved livers. Our results indicate that AST release into perfusate can be used as a screening technique to optimize preservation methods, reserving transplantation for confirming the most promising results.
已对移植存活率与肝功能之间的关系进行了研究。将Wistar大鼠肝脏在4℃下保存不同时长,然后移植到Wistar大鼠受体中。确定了两个关键时间点,移植成功率达100%的最长保存期(4小时)和移植失败率达100%的最短保存期(8小时)。在37℃保存的肝脏中也确定了类似的关键时间点(1小时和2小时)。通过离体灌注肝脏技术,对在4℃或37℃下保存至关键时间点的其他大鼠肝脏的肝功能进行了研究。两项肝功能测试,即灌注液中的AST和LDH浓度,在不同保存组以及同一保存组内均能区分存活肝脏和非存活肝脏。AST在区分存活肝脏和非存活肝脏方面表现最佳。一些功能,如灌注液中的ALT浓度,仅在保存组内能够区分存活和非存活的同种异体移植物。其他肝功能对保存温度的敏感性高于同种异体移植物的存活率。在任一关键时间点进行冷保存后的耗氧量约为对照水平的两倍。在温热保存的肝脏中尿素生成远低于对照水平,但在冷保存的肝脏中几乎正常。我们的结果表明,灌注液中AST的释放可作为一种筛选技术来优化保存方法,保留移植以确认最有前景的结果。