主动脉瓣同种异体移植物应该再次冷冻保存吗？

Should the aortic valve homograft be recryopreserved?

作者信息

Ohkado A, Hachida M, Furukawa H, Lu H, Hanayama N, Hoshi H, Koyanagi H

机构信息

Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical College.

出版信息

Ann Thorac Surg. 1998 Apr;65(4):1083-6. doi: 10.1016/s0003-4975(98)00095-2.

DOI:10.1016/s0003-4975(98)00095-2

PMID:9564932

Abstract

BACKGROUND

The number of homograft donors is limited and the once-thawed homograft may be unsuitable for the recipient and obliged to be wasted. The purpose of this study was to investigate the possibility of recryopreserving and using the once-thawed homograft for another patient.

METHODS

Canine aortic valve leaflets were frozen to -80 degrees C by a programmed freezer, stored in liquid nitrogen, and thawed after 1 week. A subgroup of leaflets was left at 4 degrees C for 15 minutes, re-cryopreserved, and thawed after 1 week. Pathologic and flow cytometric evaluations were performed.

RESULTS

After thawing, by pathology, alignment of the fibers was acceptably maintained but the membrane and cytoplasm of the fibroblast were damaged. These findings were not significantly aggravated even after rethawing. By flow cytometry, fibroblast viability was 90.7%+/-1.7% immediately after thawing, 87.6%+/-1.0% after thawing for 15 minutes at 4 degrees C, 63.7%+/-2.7% during refreezing at 0 degrees C, and 39.4%+/-4.3% after rethawing.

CONCLUSIONS

From the standpoint of fibroblast viability, it is not possible to recryopreserve the once-cryopreserved and thawed aortic valve homograft.

摘要

背景

同种异体移植物供体数量有限，且经一次解冻的同种异体移植物可能不适用于受体，不得不被废弃。本研究的目的是探讨将经一次解冻的同种异体移植物再次冷冻保存并用于另一位患者的可能性。

方法

将犬主动脉瓣叶用程序降温冷冻机冷冻至-80℃，储存于液氮中，1周后解冻。将一部分瓣叶在4℃放置15分钟，再次冷冻保存，1周后解冻。进行病理和流式细胞术评估。

结果

解冻后，病理检查显示纤维排列维持良好，但成纤维细胞的细胞膜和细胞质受损。即使再次解冻后，这些表现也未显著加重。流式细胞术检测显示，解冻后即刻成纤维细胞活力为90.7%±1.7%，在4℃解冻15分钟后为87.6%±1.0%，在0℃再次冷冻过程中为63.7%±2.7%，再次解冻后为39.4%±4.3%。