Gonzalez A P, Sepulveda S, Massberg S, Baumeister R, Menger M D
Institute for Surgical Research and Surgical Clinic, University of Munich, Germany.
Transplantation. 1994 Aug 27;58(4):403-8. doi: 10.1097/00007890-199408270-00002.
With the use of in vivo fluorescence microscopy we have analyzed microvascular reperfusion injury of small bowel isograft transplants in rats. Following 1 hr cold storage in University of Wisconsin solution, the small bowel was transplanted heterotopically, and the intestinal microcirculation was quantitatively analyzed 20-60 min after onset of reperfusion. The intestinal grafts' capillary perfusion of both the mucosa and the circular and longitudinal muscles was not found altered when compared with the intestinal capillary perfusion of sham-operated controls. In contrast, leukocyte-endothelial cell interaction, including leukocyte rolling (40 +/- 5%) and sticking (280 +/- 100 mm-2) in submucosal postcapillary venules, was significantly increased when compared with nontransplanted controls (12 +/- 8% and 20 +/- 10 mm-2, P < 0.01 and P < 0.05, respectively). Leukocyte-endothelial cell interaction was associated with a marked alteration of lymphatic capillary drainage, as indicated by the low functional density of lymphatic microvessels of 10.2 +/- 6.1 cm-1 (P < 0.01 vs. sham-operated controls (39.2 +/- 6.1 cm-1)). From these results we propose that leukocyte-endothelial cell interaction, not capillary "no-reflow," is the primary step in the manifestation of microvascular reperfusion injury following a short period of cold ischemia in small bowel grafts.
利用体内荧光显微镜技术，我们分析了大鼠小肠同种异体移植中的微血管再灌注损伤。在威斯康星大学溶液中冷藏1小时后，将小肠进行异位移植，并在再灌注开始后20 - 60分钟对肠道微循环进行定量分析。与假手术对照组的肠道毛细血管灌注相比，未发现肠移植的黏膜、环形肌和纵行肌的毛细血管灌注有改变。相反，与未移植对照组（分别为12±8%和20±10 mm-2）相比，黏膜下毛细血管后微静脉中的白细胞-内皮细胞相互作用，包括白细胞滚动（40±5%）和黏附（280±100 mm-2）显著增加（P < 0.01和P < 0.05）。白细胞-内皮细胞相互作用与淋巴管引流的明显改变有关，表现为淋巴管微血管功能密度低，为10.2±6.1 cm-1（与假手术对照组（39.2±6.1 cm-1）相比，P < 0.01）。根据这些结果，我们提出白细胞-内皮细胞相互作用而非毛细血管“无复流”是小肠移植物短期冷缺血后微血管再灌注损伤表现的主要步骤。
