Ruwart M J, Kaminski D L, Barner H B
Trans Am Soc Artif Intern Organs. 1976;22:223-8.
Normothermic blood perfusions of isolated canine liver were undertaken to determine the most sensitive and reliable indicators of viability. Perfusate flow rates and arterial and portal venous pressures were monitored. Arterial and venous concentrations of potassium, pyruvate, serum glutamic oxaloacetic transaminase, and oxygen were monitored and the values stored on magnetic tape for computerized calculation of outputs. Continuous evaluation of taurocholate concentration in the perfusate allowed adjustment of infusion rate to provide a constant flow of bile across the hapatocytes. Pyruvate output, portal venous resistance, serum glutamic oxaloacetic transaminase output and potassium output provided the earliest indices of deterioration. Bile flow and oxygen consumption remained constant until irreversible outflow block had occured. The earliest and most constant parameter signaling deteoration of the ex vivo liver was pyruvate output. The deteriorating liver released pyruvate into the perfusate, while the functioning organ consumed or maintained the available substrate. Since pyruvate output occurs before the onset of irreversible damage, measures can be enacted to reverse the deterioration. Restoration of the preparation can be evaluated through the cessation of pyruvate output.
进行了离体犬肝的常温血液灌注，以确定最敏感和可靠的活力指标。监测灌注液流速以及动脉和门静脉压力。监测动脉和静脉中的钾、丙酮酸、血清谷氨酸草酰乙酸转氨酶和氧的浓度，并将这些值存储在磁带上，以便通过计算机计算输出结果。持续评估灌注液中牛磺胆酸盐的浓度，可调整输注速率，以确保胆汁持续流经肝细胞。丙酮酸输出、门静脉阻力、血清谷氨酸草酰乙酸转氨酶输出和钾输出是最早出现恶化的指标。在发生不可逆的流出道阻塞之前，胆汁流量和氧消耗保持恒定。离体肝脏恶化的最早且最恒定的信号参数是丙酮酸输出。肝脏功能恶化时会将丙酮酸释放到灌注液中，而功能正常的器官则消耗或维持可用的底物。由于丙酮酸输出发生在不可逆损伤出现之前，因此可以采取措施扭转这种恶化。可通过丙酮酸输出停止来评估制剂的恢复情况。
