Hayashi M, Tokunaga Y, Fujita T, Tanaka K, Yamaoka Y, Ozawa K
Second Department of Surgery, Faculty of Medicine, Kyoto University, Japan.
Transplantation. 1993 Aug;56(2):282-7. doi: 10.1097/00007890-199308000-00005.
Clinical experience suggests that grafts obtained from steatotic livers result in primary nonfunction more frequently than those from nonsteatotic livers. To date, however, only a few studies have been done to verify the accuracy of this observation. To investigate the effects of cold preservation on steatotic liver viability, liver grafts obtained from rats fed with a choline-deficient diet were transplanted after periods of cold preservation. Recipient survival rates with normal liver grafts were 8/8 (100%) and those with steatotic liver grafts were 7/8 (88%) (P > 0.05) after 1-hr preservation with UW solution. After 9-hr preservation, however, these rates decreased significantly to 0/8 (0%) with steatotic grafts (P < 0.01), but were not significantly decreased with normal grafts. LDH levels in the effluent at the time of transplantation were 133 IU/L (1-hr) and 512 IU/L (9-hr) in normal livers, but in steatotic livers these were elevated to 598 and 3141 IU/L, respectively (P < 0.01). Recovery rates of hepatic blood flow measured by laser Doppler flowmeter after revascularization were 99% (1-hr) and 96% (9-hr) in normal grafts, but in steatotic grafts they were 98% (1-hr) and 63% (9-hr, P < 0.01). In addition, the oxidative phosphorylation ability of liver mitochondria obtained from steatotic grafts was decreased significantly after cold preservation. The present results suggest that steatotic liver grafts are prone to lose their viability more easily than normal liver grafts after prolonged periods of cold preservation due to a combination of causes.
临床经验表明，取自脂肪变性肝脏的移植物比取自非脂肪变性肝脏的移植物更常导致原发性无功能。然而，迄今为止，仅有少数研究来验证这一观察结果的准确性。为了研究冷保存对脂肪变性肝脏活力的影响，取自喂食胆碱缺乏饮食大鼠的肝脏移植物在经过不同时长的冷保存后进行移植。用UW溶液保存1小时后，正常肝脏移植物的受体存活率为8/8（100%），脂肪变性肝脏移植物的受体存活率为7/8（88%）（P>0.05）。然而，保存9小时后，脂肪变性移植物的这些比率显著下降至0/8（0%）（P<0.01），而正常移植物的比率没有显著下降。移植时流出液中的乳酸脱氢酶（LDH）水平在正常肝脏中为133 IU/L（1小时）和512 IU/L（9小时），但在脂肪变性肝脏中分别升高至598和3141 IU/L（P<0.01）。血管再通后用激光多普勒血流仪测量的肝血流恢复率在正常移植物中为99%（1小时）和96%（9小时），但在脂肪变性移植物中为98%（1小时）和63%（9小时，P<0.01）。此外，冷保存后取自脂肪变性移植物的肝脏线粒体的氧化磷酸化能力显著降低。目前的结果表明，由于多种原因，脂肪变性肝脏移植物在长时间冷保存后比正常肝脏移植物更容易失去活力。
