Himmelreich G, Dooijewaard G, Neuhaus P, Kluft C, Bechstein W O, Riess H
Department of Internal Medicine, University Clinic Rudolf Virchow, Berlin, Germany.
Thromb Haemost. 1994 Jan;71(1):12-4.
In orthotopic liver transplantation (OLT) the graft liver is perfused with arterial blood prior to the opening of the hepatocaval anastomosis. In the present investigation we focused on the reperfusion of the graft liver in order to study the hepatic influence in the regulation of urokinase-type plasminogen activator (u-PA levels). Two different aprotinin schedules were used in 43 patients. We measured u-PA levels in the perfusate and in the corresponding systemic circulation. u-PA levels were higher in the perfusate as compared to systemic blood samples despite the dilution of the perfusate sample by the preservation fluid. This suggests u-PA secretion by the graft liver. In the presence of lower aprotinin levels signs of single-chain u-PA (scu-PA) activation was in the perfusate more prominent than systemically--a difference which was not seen in the presence of higher aprotinin levels. This seems to be an argument for the effectiveness of higher dosed aprotinin application in preventing scu-PA activation.
在原位肝移植（OLT）中，在肝腔静脉吻合口开放之前，移植肝用动脉血灌注。在本研究中，我们重点关注移植肝的再灌注，以研究肝脏对尿激酶型纤溶酶原激活剂（u-PA水平）调节的影响。43例患者使用了两种不同的抑肽酶给药方案。我们测量了灌注液和相应体循环中的u-PA水平。尽管灌注液样本被保存液稀释，但与全身血样相比，灌注液中的u-PA水平更高。这表明移植肝分泌u-PA。在抑肽酶水平较低的情况下，灌注液中单链u-PA（scu-PA）激活的迹象比全身更明显——在抑肽酶水平较高的情况下未观察到这种差异。这似乎支持了高剂量应用抑肽酶在预防scu-PA激活方面的有效性。
