Minor T, Vollmar B, Menger M D, Isselhard W
Department of Surgery, University of Bonn, Germany.
Transpl Int. 1998;11(1):32-7. doi: 10.1007/s001470050099.
The aim of the present study was to evaluate the potential of Celsior, a recently developed cardioplegic and heart storage solution, to protect the small bowel during ischemic storage. Small bowel segments were isolated from rats, flushed with either UW or Celsior solution, and cold-stored for 18 h at 4 degrees C in the respective solution. After ischemic storage, some preparations were freeze-clamped for analysis of tissue metabolites while other preparations were tested for structural and functional integrity by isolated perfusion in vitro using a previously validated model. After 18 h of ischemic storage no significant differences were seen between Celsior and UW with regard to the development of edema, energy charge, or creatine phosphate, but lactate accumulation was significantly reduced in the Celsior group, although glucose catabolism was not inhibited. Histological evaluation of the cold-stored organs showed no differences with regard to structural integrity between the two groups. Total vascular resistance upon reperfusion was significantly lower in the Celsior group (666 +/- 126 vs 827 +/- 88 MPa s m-3*), as was the intestinal release of LDH (9.7 +/- 4.4 vs 18.2 +/- 4.6 U/l*). Carbohydrate absorption from the intestinal lumen amounted to venous effluent concentrations of 0.58 +/- 0.24 vs 0.18 +/- 0.15 mg% * of galactose in the Celsior and UW groups, respectively. Within the limits of this in vitro pilot study, Celsior provided better postischemic recovery of the small bowel than UW in terms of vascular perfusion characteristics, enzyme release, and carbohydrate absorption and may, thus, be considered a suitable alternative for intestinal organ preservation.
本研究的目的是评估最近开发的心脏停搏和心脏保存溶液Celsior在缺血保存期间保护小肠的潜力。从小鼠分离出小肠段,用UW溶液或Celsior溶液冲洗,然后在4℃下于各自溶液中冷藏18小时。缺血保存后,一些标本进行冷冻钳夹以分析组织代谢物,而其他标本则使用先前验证的模型通过体外分离灌注测试结构和功能完整性。缺血保存18小时后,Celsior组和UW组在水肿形成、能量电荷或磷酸肌酸方面未见显著差异,但Celsior组的乳酸积累显著减少,尽管葡萄糖分解代谢未受抑制。冷藏器官的组织学评估显示两组在结构完整性方面无差异。Celsior组再灌注时的总血管阻力显著较低(666±126对827±88 MPa s m-3*),小肠LDH释放也较低(9.7±4.4对18.2±4.6 U/l*)。Celsior组和UW组从小肠腔吸收的碳水化合物分别导致静脉流出物中半乳糖浓度为0.58±0.24对0.18±0.15 mg%*。在这项体外初步研究的范围内,就血管灌注特征、酶释放和碳水化合物吸收而言,Celsior比UW能使小肠在缺血后恢复得更好,因此可被视为肠道器官保存的合适替代品。