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低温肾脏保存与移植后呼吸链功能障碍的无创测量

Non-invasive measurement of respiratory chain dysfunction following hypothermic renal storage and transplantation.

作者信息

Thorniley M S, Lane N J, Manek S, Green C J

机构信息

Section of Surgical Research, MRC Clinical Research Centre, Middlesex, England, United Kingdom.

出版信息

Kidney Int. 1994 May;45(5):1489-96. doi: 10.1038/ki.1994.194.

Abstract

Ischemia/reperfusion (IR) damage is a major cause of dysfunction in transplanted organs. The objective of the present study was to correlate in vivo measurements of respiratory chain (RC) function with histological and physiological parameters. Non-invasive in situ (surface fluorescence) measurements of mitochondrial NADH and near infrared spectroscopic measurements of cyt aa3 were made in unstored (Group 1) and 72 hour stored (1 to 2 degrees C) (Group 2) autografted rabbit kidneys. The effect of sodium pentobarbitone on NADH levels was investigated. In Group 1, there was a significant change in the redox state of cyt aa3 in all (N = 6) kidneys on reperfusion which correlated with organ viability and increased NADH oxidation and minimal edema on histological examination. In Group 2 there was no significant change in cyt aa3 compared to baseline, and this correlated with poor long term organ viability, slower NADH oxidation, and severe cortical edema. Pentobarbitone inhibition of the RC resulted in rapid and complete reduction of NAD+ in Group 1, but none or only a slight reduction in Group 2. The results demonstrate that it might be possible in future to predict organ viability and histological changes by non-invasive measurements of RC dysfunction in the clinical transplant situation.

摘要

缺血/再灌注(IR)损伤是移植器官功能障碍的主要原因。本研究的目的是将呼吸链(RC)功能的体内测量结果与组织学和生理学参数相关联。对未保存(第1组)和保存72小时(1至2摄氏度)(第2组)的自体移植兔肾进行了线粒体NADH的非侵入性原位(表面荧光)测量和细胞色素aa3的近红外光谱测量。研究了戊巴比妥钠对NADH水平的影响。在第1组中,所有(N = 6)肾脏再灌注时细胞色素aa3的氧化还原状态均有显著变化,这与器官活力相关,且组织学检查显示NADH氧化增加和水肿最小。在第2组中,与基线相比细胞色素aa3无显著变化,这与长期器官活力差、NADH氧化较慢和严重皮质水肿相关。戊巴比妥钠对呼吸链的抑制导致第1组中NAD +迅速完全还原,但第2组中无还原或仅有轻微还原。结果表明,未来在临床移植情况下通过非侵入性测量呼吸链功能障碍可能预测器官活力和组织学变化。

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