Surgical Research Department, University Hospital Essen, Essen, Germany.
Artif Organs. 2024 Feb;48(2):150-156. doi: 10.1111/aor.14669. Epub 2023 Oct 21.
Gradual warming up of cold stored organ grafts using a controlled machine perfusion protocol facilitates restitution of cellular homeostasis and mitigates rewarming injury by adapted increase of temperature and metabolism. The aim of the present study was to compare intra- and extracellular type perfusion media for the use in machine perfusion-assisted rewarming from hypo- to normothermia.
Rat livers were retrieved 20 min after cardiac arrest. After 18 h of cold storage (CS) with or without additional 2 h of rewarming machine perfusion from 8°C up to 35°C with either diluted Steen solution or with Belzer MPS, liver functional parameters were evaluated by an established ex vivo reperfusion system.
Rewarming machine perfusion with either solution significantly improved graft performance upon reperfusion in terms of increased bile production, less enzyme release, and reduced lipid peroxidation compared to CS alone. Cellular apoptosis (release of caspase-cleaved keratin 18) and release of tumor necrosis factor were only reduced significantly after machine perfusion with Belzer MPS. Histological evaluation did not disclose any major morphological damage in any of the groups.
Within the limitation of our model, the use of Belzer MPS seems to be an at least adequate alternative to a normothermic medium like Steen solution for rewarming machine perfusion of cold liver grafts.
使用受控机器灌注方案逐渐加热冷藏器官移植物有助于恢复细胞内稳态，并通过适应增加温度和新陈代谢来减轻复温损伤。本研究的目的是比较用于从低温到正常体温的机器灌注辅助复温的细胞内和细胞外灌注介质。
心脏停搏后 20 分钟从大鼠肝脏中取出。在冷保存（CS）期间，用稀释的 Steen 溶液或 Belzer MPS 进行 2 小时的复温机器灌注，或不进行复温机器灌注，进行 18 小时 CS 后，通过建立的离体再灌注系统评估肝功能参数。
与 CS 单独相比，用任何一种溶液进行复温机器灌注均可显著改善再灌注后的移植物功能，表现为胆汁产量增加、酶释放减少和脂质过氧化减少。只有在用 Belzer MPS 进行复温机器灌注后，细胞凋亡（半胱氨酸天冬氨酸蛋白酶切割角蛋白 18 的释放）和肿瘤坏死因子的释放才显著降低。组织学评估未发现任何组有明显的形态学损伤。
在我们的模型范围内，与像 Steen 溶液这样的常温介质相比，Belzer MPS 的使用似乎至少是冷藏肝移植物复温机器灌注的一种合适替代方案。
