Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, 51 Blossom St, Boston, MA, 02114, USA.
Shriners Hospitals for Children, Boston, MA, USA.
Sci Rep. 2021 Nov 30;11(1):23128. doi: 10.1038/s41598-021-02417-6.
In transplantation, livers are transported to recipients using static cold storage (SCS), whereby livers are exposed to cold ischemic injury that contribute to post-transplant risk factors. We hypothesized that flushing organs during procurement with cold preservation solutions could influence the number of donor blood cells retained in the allograft thereby exacerbating cold ischemic injury. We present the results of rat livers that underwent 24 h SCS after being flushed with a cold University of Wisconsin (UW) solution versus room temperature (RT) lactated ringers (LR) solution. These results were compared to livers that were not flushed prior to SCS and thoroughly flushed livers without SCS. We used viability and injury metrics collected during normothermic machine perfusion (NMP) and the number of retained peripheral cells (RPCs) measured by histology to compare outcomes. Compared to the cold UW flush group, livers flushed with RT LR had lower resistance, lactate, AST, and ALT at 6 h of NMP. The number of RPCs also had significant positive correlations with resistance, lactate, and potassium levels and a negative correlation with energy charge. In conclusion, livers exposed to cold UW flush prior to SCS appear to perform worse during NMP, compared to RT LR flush.
在移植中，肝脏通过静态冷保存（SCS）运输到受体，在此过程中肝脏会受到冷缺血损伤，从而增加移植后的风险因素。我们假设在获取器官时用冷保存液冲洗可以影响供体血细胞在移植物中的保留数量，从而加剧冷缺血损伤。我们介绍了大鼠肝脏的结果，这些肝脏在 SCS 前用 UW 冷保存液冲洗，而不是室温（RT）乳酸林格氏液（LR）冲洗。将这些结果与未经 SCS 冲洗的肝脏和未进行 SCS 但充分冲洗的肝脏进行比较。我们使用在常温机器灌注（NMP）期间收集的活力和损伤指标以及通过组织学测量的外周细胞（RPC）保留数量来比较结果。与冷 UW 冲洗组相比，在 NMP 的 6 小时时，用 RT LR 冲洗的肝脏具有更低的阻力、乳酸、AST 和 ALT。RPC 的数量也与阻力、乳酸和钾水平呈显著正相关，与能量电荷呈负相关。总之，与 RT LR 冲洗相比，在 SCS 前用 UW 冷冲洗液冲洗的肝脏在 NMP 期间的表现似乎更差。
