增加供肝的肝糖原贮备减轻心脏停搏大鼠供肝的热缺血再灌注损伤  

The experimental study on the relationship between the hepatic glycogen content and the liver transplantation of non-heart-beating donor

作　　者：邵堂雷[1] 杨卫平[1] 蔡伟耀[1] 陈皓[1] 严佶祺[1] 彭承宏[1] 李宏为[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院外科,200025

出　　处：《中华器官移植杂志》2007年第12期733-736,共4页Chinese Journal of Organ Transplantation

摘　　要：目的探讨肝移植术前增加供肝的肝糖原贮备能否减轻心脏停搏大鼠供肝的热缺血再灌注损伤。方法雄性SD大鼠作为肝移植的供、受者被随机分为A、B、C三组。A组供者正常饮水;B组供者术前连续4 d饮糖水;C组供者在B组的基础上于供肝获取前3～4 h注射500 g/L的葡萄糖。A、B、C三组再按供者经历的心脏停搏时间(心脏停搏60 min、90 min、120 min和150 min)各分为4个小组,行原位肝移植术并检测移植肝组织中肝糖原和ATP的含量;同时观察受者术后1周存活率以及血清丙二醛(MDA)和超氧化物歧化酶(SOD)的水平。结果B、C两组供肝的肝糖原贮备和ATP含量均明显高于A组(P<0.01);B-60 min、B-90 min、B-120 min和C-90 min、C-120 min、C-150 min组受者的1周存活率分别为80%、50%、10%和70%、60%、20%,部分受者可长期存活;B、C两组受者MDA水平明显低于A组,SOD水平明显高于A组(P<0.05)。结论术前增加大鼠供肝的肝糖原贮备能明显减轻供肝的热缺血再灌注损伤,减少了术后原发性移植肝无功能的发生,提高了心脏停搏供肝移植术后的存活率。Objective To study whether the warm ischemia-reperfusion injury can be alleviated if the hepatic glycogen content were increased before liver transplantation. Methods The male SD rats as donors and recipients were divided into groups A, B and C randomly. In group A, the rats were allowed access to solid and water ad libitum; In group B, the rats drank glucose liquor for 4 days prior to liver harvesting; In group C, the rats were intravenously injected with 50% glucose besides the protocol in group B 3-4 h prior to liver harvesting. According to the non-heart-beating time （the non- heart-beating time were set into 60, 90, 120 and 150 min）, the rats in groups A, B and C were divided into 4 subgroups, and the orthotopic liver transplantation was performed and the hepatic glycogen and ATP contents were measured. The one-week survival rate and the serum levels of MDA and SOD in the recipients were determined after liver transplantation. Results The hepatic glycogen and ATP contents in groups B and C were more than those in group A significantly （P〈0. 01）. The one-week sur- vival rate in subgroups B （60, 90, 120 min） was 80%, 50 %, 10 % and in subgroups C （90, 120, 150 min） was 70%, 60%, 20%, respectively. Some recipients could achieve long-term survival. The serum levels of MDA in groups B and C were lower than in group A, and the levels of SOD in groups B and C were higher than those in group A （P〈0. 05）. Conclusion With the increase of the hepatic glycogen content before liver harvesting, the warm ischemia-reperfusion injury of the grafted liver can be alleviated and incidence of the primary non-function of grafted liver can be reduced, and the survival rate of recipients in the non-heart-beating-donor also can be improved after liver transplantation.

关 键 词：心脏停搏 供者选择 肝糖原 肝移植 再灌注损伤 大鼠 

分 类 号：R657.3[医药卫生—外科学]