Kuroda Y, Morita A, Fujino Y, Tanioka Y, Ku Y, Saitoh Y
First Department of Surgery, Kobe University School of Medicine, Japan.
Transplantation. 1993 Nov;56(5):1087-90. doi: 10.1097/00007890-199311000-00007.
We have demonstrated that a two-layer (University of Wisconsin solution [UW]/perfluorochemical [PFC]) cold storage method restores the function of ischemically damaged pancreas during 24-hr preservation in canine autotransplantation model. The purpose of this study was to examine the possibility of a long-term preservation of the ischemically damaged pancreas by the two-layer (UW/PFC) method. After 60 or 90 min of warm ischemic time, pancreas grafts were preserved by the two-layer (UW/PFC) method or a simple cold storage in UW alone for up to 96 hr. A K value of i.v. glucose tolerance test more than 1.0 2 weeks after autotransplantation was considered successful preservation. After 60 min warm ischemia, limitation of preservation time by the simple cold storage in UW was 24 hr (5/5 100% and 0/5 0%; 24- and 48-hr preservation, respectively). However, the two-layer method made it possible to extend the preservation time up to 48 hr (5/5 100%, 5/5 100%, 2/5 40%, and 0/5 0%; 24-, 48-, 72-, and 96-hr preservation, respectively). After 90 min warm ischemia, the simple cold storage in UW was not effective even for 24-hr preservation (0/5 0%). However, 48-hr preservation was successful by the two-layer (UW/PFC) method (5/5 100%, 5/5 100%, and 0/5 0%; 24-, 48-, and 72-hr-preservation, respectively). After preservation by the two-layer (UW/PFC) method, ATP tissue concentrations of viable grafts were significantly higher compared with nonviable grafts (9.11 +/- 3.05 (n = 22) versus 5.22 +/- 1.02 (n = 13) mumol/g dry wt, P < 0.001). Based on analysis of individual ATP for each graft, if an ATP concentration of 6.0 mumol/g dry weight was determined as a critical value for doing the transplant, sensitivity, specificity, positive predictive value, and negative predictive value were 100%, 84.6%, 91.7%, and 94.3%, respectively. This study clearly demonstrated that 48-hr preservation of the canine pancreas subjected to either 60 or 90 min warm ischemia was successfully achieved by the two-layer (UW/PFC) cold storage method, and ATP tissue concentration at the end of preservation by this method would predict the post-transplant outcome of the ischemically damaged pancreas just prior to transplantation.
我们已经证明，在犬自体移植模型中，一种双层（威斯康星大学溶液[UW]/全氟化合物[PFC]）冷藏方法可在24小时保存期内恢复缺血损伤胰腺的功能。本研究的目的是探讨通过双层（UW/PFC）方法长期保存缺血损伤胰腺的可能性。在60或90分钟的热缺血时间后，胰腺移植物通过双层（UW/PFC）方法或仅在UW中简单冷藏保存长达96小时。自体移植后2周静脉内葡萄糖耐量试验的K值大于1.0被认为是成功保存。热缺血60分钟后，在UW中简单冷藏的保存时间限制为24小时（分别为5/5 100%和0/5 0%；24小时和48小时保存）。然而，双层方法使保存时间延长至48小时成为可能（分别为5/5 100%、5/5 100%、2/5 40%和0/5 0%；24小时、48小时、72小时和96小时保存）。热缺血90分钟后，即使保存24小时，在UW中简单冷藏也无效（0/5 0%）。然而，通过双层（UW/PFC）方法48小时保存成功（分别为5/5 100%、5/5 100%和0/5 0%；24小时、48小时和72小时保存）。通过双层（UW/PFC）方法保存后，存活移植物的ATP组织浓度与非存活移植物相比显著更高（9.11±3.05（n = 22）对5.22±1.02（n = 13）μmol/g干重，P < 0.001）。基于对每个移植物个体ATP的分析，如果将6.0μmol/g干重的ATP浓度确定为进行移植的临界值，则敏感性、特异性、阳性预测值和阴性预测值分别为100%、84.6%、91.7%和94.3%。本研究清楚地表明，通过双层（UW/PFC）冷藏方法成功实现了对经历60或90分钟热缺血的犬胰腺进行48小时保存，并且通过该方法在保存结束时的ATP组织浓度将预测缺血损伤胰腺移植前的移植后结果。
