Cavallari N, Abebe W, Mingoli A, Sapienza P, Hunter W J, Agrawal D K, Cavallaro A, Edwards J D
Creighton Vascular Center, Creighton University School of Medicine, Omaha, Neb., USA.
Surgery. 1997 Jan;121(1):64-71. doi: 10.1016/s0039-6060(97)90184-7.
Suboptimal preservation of autologous veins in storage solutions causes endothelial cell damage that can contribute to graft failure. The purpose of this study was to compare the effects of short-term storage of veins in autologous whole blood (AWB), 0.9% normal saline solution (NS), and University of Wisconsin solution (UWs) on vein structure and function after grafting.
Autogenous jugular and femoral veins were atraumatically harvested from mongrel dogs. One vein segment was immediately implanted to serve as a control, and the other segments were stored for 45 minutes in AWB, NS, or UWs. The veins were implanted as reversed interposition graft in the carotid or femoral arteries. After 6 weeks light and scanning electron microscopy and isometric tension studies were performed on explanted vein grafts.
Morphologic studies revealed an intact endothelium that stained positively for factor VIII. Intimal thickness was similar between controls (48 +/- 12 microns) and veins stored in UWs (53 +/- 8 microns) (p = not significant), but it was significantly increased in veins stored in AWB (151 +/- 29 microns) and NS (149 +/- 18 microns) (p < 0.05). Sensitivity and maximum contraction to norepinephrine were not altered in veins preserved in UWs (6.0 +/- 0.1 mumol/L and 0.19 +/- 0.02 gm/mm2) but were significantly reduced (p < 0.05) in those stored in AWB (7.2 +/- 0.1 mumol/L and 0.08 +/- 0.02 gm/mm2) and NS (7.0 +/- 0.3 mumol/L and 0.09 +/- 0.02 gm/mm2) compared with controls (5.9 +/- 0.2 mumol/L and 0.20 +/- 0.02 gm/mm2). The sensitivity and maximum relaxation to acetylcholine and sodium nitroprusside of veins preserved in AWB, NS, and UWs were similar to controls (p = not significant).
Vein storage in UWs preserves smooth muscle cell function compared with veins stored in NS or AWB. Therefore UWs is a more suitable medium for short-term preservation of veins in cardiovascular operation.
自体静脉在储存溶液中的保存效果欠佳会导致内皮细胞损伤，这可能会导致移植物失败。本研究的目的是比较自体全血（AWB）、0.9%生理盐水溶液（NS）和威斯康星大学溶液（UWs）对静脉进行短期储存后，移植后静脉结构和功能的影响。
从杂种犬身上无创采集颈静脉和股静脉。将一段静脉立即植入作为对照，其他段静脉分别在AWB、NS或UWs中储存45分钟。将静脉作为逆行插入移植物植入颈动脉或股动脉。6周后，对取出的静脉移植物进行光镜和扫描电镜检查以及等长张力研究。
形态学研究显示内皮完整，因子VIII染色呈阳性。对照组（48±12微米）和储存在UWs中的静脉（53±8微米）内膜厚度相似（p值无统计学意义），但储存在AWB（151±29微米）和NS（149±18微米）中的静脉内膜厚度显著增加（p<0.05）。储存在UWs中的静脉（6.0±0.1微摩尔/升和0.19±0.02克/平方毫米）对去甲肾上腺素的敏感性和最大收缩力未改变，但与对照组（5.9±0.2微摩尔/升和0.20±0.02克/平方毫米）相比，储存在AWB（7.2±0.1微摩尔/升和0.08±0.02克/平方毫米）和NS（7.0±0.3微摩尔/升和0.09±0.02克/平方毫米）中的静脉显著降低（p<0.05）。储存在AWB、NS和UWs中的静脉对乙酰胆碱和硝普钠的敏感性和最大舒张度与对照组相似（p值无统计学意义）。
与储存在NS或AWB中的静脉相比，储存在UWs中的静脉能保留平滑肌细胞功能。因此，UWs是心血管手术中静脉短期保存更合适的介质。
