Wolf R F, den Butter G, Kamman R L, Deketh H P, Sluiter W J, Slooff M J
Department of Surgery, University Hospital, Groningen, The Netherlands.
Transplantation. 1994 Apr 27;57(8):1189-94.
To determine the relation between tissue hydration state--as indicated by tissue proton magnetic resonance relaxation times--in UW-preserved human donor livers and viability parameters of the donor and early graft function, "ex vivo" magnetic resonance relaxometry was performed with a clinical MR imaging system. Relaxometric data were obtained from MR images in which signal intensities were directly proportional to T1 and T2. Forty-three subsequently transplanted livers and five discarded livers were studied. The donor serum concentrations of direct and total bilirubin had a positive correlation with T1 (P < 0.05 and P < 0.01, respectively). Sequential measurements in 7 livers demonstrated a firm time relation between the cold storage time and the length of the relaxation times. As cold storage time lengthened, T1 and T2 shortened. T1 of the donor liver showed a significant negative correlation with recipient ASAT and ALAT values on days 1, 2, and 3 after transplantation. T1 in the discarded group was significantly higher than T1 in the accepted group. T2 was not different in the two groups. It is concluded that in UW-preserved human donor livers, the tissue hydration state, as indicated by the tissue MR relaxation times, is largely independent of the clinical condition of the organ donor and the preservation procedure. An optimum tissue hydration state, in UW-preserved donors liver might have protective properties against parenchymal damage, although the clinical consequences appear to be of minor importance. The capacity of relaxometry as a discriminative instrument to accept or to discard donor livers is poor.
为了确定UW保存的人类供体肝脏中组织水合状态(以组织质子磁共振弛豫时间表示)与供体生存参数及早期移植肝功能之间的关系,使用临床磁共振成像系统进行了“离体”磁共振弛豫测量。弛豫测量数据从信号强度与T1和T2成正比的磁共振图像中获取。研究了43个随后移植的肝脏和5个废弃肝脏。供体血清直接胆红素和总胆红素浓度与T1呈正相关(分别为P < 0.05和P < 0.01)。对7个肝脏的连续测量表明,冷藏时间与弛豫时间长度之间存在确定的时间关系。随着冷藏时间延长,T1和T2缩短。供体肝脏的T1与移植后第1、2和3天受体的ASAT和ALAT值呈显著负相关。废弃组的T1显著高于接受组。两组的T2无差异。得出结论,在UW保存的人类供体肝脏中,以组织磁共振弛豫时间表示的组织水合状态在很大程度上独立于器官供体的临床状况和保存程序。在UW保存的供体肝脏中,最佳组织水合状态可能对实质损伤具有保护作用,尽管临床后果似乎不太重要。弛豫测量作为区分供体肝脏是否可接受或废弃的工具,能力较差。