Sumimoto K, Matsura T, Oku J I, Fukuda Y, Yamada K, Dohi K
The Second Department of Surgery, Hiroshima University School of Medicine, Japan.
Transplantation. 1996 Nov 27;62(10):1391-8. doi: 10.1097/00007890-199611270-00003.
Preservation with University of Wisconsin (UW) solution can maintain liver graft function and produces survival rates of recipients higher than that with Euro Collins (EC) solution. To explore the underlying mechanisms, we transplanted rat livers following cold preservation with EC or UW solution for 18 hr, and measured hepatic adenine nucleotide levels, the percentage of water content, lactate levels, and endogenous antioxidant levels (alpha-tocopherol [alpha-Toc], reduced coenzyme Q9 [CoQ9H2], reduced coenzyme Q10, [CoQ1OH2] and reduced glutathione [GSH] during preservation and after transplantation. The adenosine triphosphate levels of the liver grafts preserved with UW solution recovered after reperfusion more rapidly and reached a higher level than those preserved with EC solution. UW solution caused a reduction in hepatic water content during preservation. Conversely, EC solution induced remarkable tissue edema. In addition, UW solution reduced the rate of hepatic lactate production both during preservation and after reperfusion. The concentrations of hepatic GSH, alpha-Toc, CoQ9H2, and CoQ1OH2 immediately after the graftectomy, and after the 18 hr of preservation with both EC and UW solutions, did not differ from those in the normal liver, and decreased only after transplantation. However, UW solution suppressed significantly the reduction in hepatic GSH, alpha-Toc, and CoQ9H2 after reperfusion, compared with EC solution. These results suggest that long-term cold storage induces tissue edema, reflecting a disturbance of the microcirculation during preservation, followed by parenchymal cell damage mediated by free radicals after reperfusion. The protective effects of UW solution could be attributable to the inhibition of free radical production after reperfusion.
用威斯康星大学(UW)溶液保存可维持肝移植肝功能,并使受体存活率高于用欧洲柯林斯(EC)溶液保存的情况。为探究其潜在机制,我们用EC或UW溶液对大鼠肝脏进行18小时冷保存后进行移植,并测定保存期间及移植后肝脏腺嘌呤核苷酸水平、含水量百分比、乳酸水平和内源性抗氧化剂水平(α-生育酚[α-Toc]、还原型辅酶Q9[CoQ9H2]、还原型辅酶Q10[CoQ1OH2]和还原型谷胱甘肽[GSH])。用UW溶液保存的肝移植组织再灌注后三磷酸腺苷水平恢复更快,且达到比用EC溶液保存的组织更高的水平。UW溶液在保存期间使肝脏含水量降低。相反,EC溶液导致明显的组织水肿。此外,UW溶液在保存期间及再灌注后均降低了肝脏乳酸生成率。移植切除后即刻以及用EC和UW溶液保存18小时后,肝脏GSH、α-Toc、CoQ9H2和CoQ1OH2的浓度与正常肝脏中的浓度无差异,仅在移植后降低。然而,与EC溶液相比,UW溶液显著抑制了再灌注后肝脏GSH、α-Toc和CoQ9H2的降低。这些结果表明,长期冷保存诱导组织水肿,反映保存期间微循环紊乱,随后再灌注后由自由基介导实质细胞损伤。UW溶液的保护作用可能归因于对再灌注后自由基产生的抑制。