Dutkowski P, Odermatt B, Heinrich T, Schönfeld S, Watzka M, Winkelbach V, Krysiak M, Junginger T
Department of Surgery, University of Mainz, Mainz, Germany.
J Surg Res. 1998 Dec;80(2):365-72. doi: 10.1006/jsre.1998.5491.
ATP and glycogen depletion often have been demonstrated during cold storage of the liver prior to transplantation. Suppression of events that lead to metabolic depression and to lipid peroxidation could contribute to improvement of liver preservation. A new method of liver preservation for transplantation is therefore suggested, an oscillating oxygenated hypothermic liver perfusion.
Biochemical analysis of liver tissue samples and perfusate after 10 h of perfusion by the presented oscillating perfusion model were compared with results after continuous liver perfusion for 10 h as well as with data derived from cold-stored livers over a period of 10 h. Particular reference was made to nucleotide metabolites, glycogen content, lipid peroxidation, glutathione content, glycolytic metabolites, and enzyme release before and after preservation.
Glycogen depletion occurred to the same degree in hypothermic storage and machine perfusion (oscillating as well as continuous perfusion), but the energy charge was significantly increased after oxygenated perfusion, whereas cold storage resulted in a significant energy charge depletion. In addition, perfusion by an oscillating technique yielded superior energy charge loading compared to the continuous perfusion technique and diminished the other hand lipid peroxidation.
Hypothermic oscillating oxygenated perfusion could be important for the improvement of the quality of energy-depleted organs prior to transplantation.
在肝脏移植前的冷藏过程中，经常会出现三磷酸腺苷（ATP）和糖原耗竭的情况。抑制导致代谢抑制和脂质过氧化的事件可能有助于改善肝脏保存效果。因此，提出了一种新的肝脏移植保存方法，即振荡式氧合低温肝脏灌注。
将通过所提出的振荡灌注模型灌注10小时后的肝脏组织样本和灌注液的生化分析结果，与连续肝脏灌注10小时后的结果以及10小时内冷藏肝脏的数据进行比较。特别参考了保存前后的核苷酸代谢产物、糖原含量、脂质过氧化、谷胱甘肽含量、糖酵解代谢产物和酶释放情况。
低温保存和机器灌注（振荡灌注以及连续灌注）中糖原耗竭程度相同，但氧合灌注后能量负荷显著增加，而冷藏则导致能量负荷显著降低。此外，与连续灌注技术相比，振荡技术灌注产生了更高的能量负荷，并减少了脂质过氧化。
低温振荡式氧合灌注对于改善移植前能量耗竭器官的质量可能具有重要意义。
