Schiller W R, Suriyapa C, Long R A
Br J Exp Pathol. 1979 Dec;60(6):560-74.
Our studies suggest that the perfusion rates of canine intestinal segments during extracorporeal perfusion are directly related to the quality of preservation; namely, better preserved specimens exhibit higher perfusion rates and vice versa. Production of intraluminal fluid (ILF) during preservation and following revascularization is related to the quality of preservation. Poorly preserved intestine seems generally to produce more fluid than well preserved specimens. Conversely, continuous pulsatile perfusion techniques resulted in more ILF production than specimens perfused with low-flow gravity-dependent systems. Ex vivo intestinal perfusion resulted in organ oedema inversely proportional to the quality of preservation. Poor preservation is also associated with washout of potassium, lactic dehydrogenase, and tissue acidosis both during preservation and revascularization. Perfusion with a high concentration of potassium ions results in poor preservation presumably owing to vasoconstriction. Mucosal malperfusion as demonstrated by the Microfil technique is the circulatory abnormality most closely associated with inadequate preservation. Smooth-muscle function, as measured by electrical activity recordings, is well preserved by pulsatile flow methods, whereas gravity perfusion results in disorganized and spastic muscular activity. The best preservation appeared to be obtained by the use of pulsatile flow with cryoprecipitated plasma as the perfusate.
我们的研究表明,犬肠道段在体外灌注期间的灌注率与保存质量直接相关;也就是说,保存较好的标本表现出较高的灌注率,反之亦然。保存期间及再灌注后肠腔内液体(ILF)的产生与保存质量有关。保存不佳的肠道似乎通常比保存良好的标本产生更多的液体。相反,连续搏动灌注技术比采用低流量重力依赖系统灌注的标本产生更多的ILF。离体肠道灌注导致器官水肿,与保存质量成反比。保存不佳还与保存期间及再灌注期间钾、乳酸脱氢酶的洗脱以及组织酸中毒有关。高浓度钾离子灌注导致保存不佳,可能是由于血管收缩。通过微丝技术证实的黏膜灌注不足是与保存不充分最密切相关的循环异常。通过电活动记录测量的平滑肌功能,采用搏动流方法能得到良好保存,而重力灌注则导致肌肉活动紊乱和痉挛。使用搏动流并以冷沉淀血浆作为灌注液似乎能获得最佳保存效果。