Celsior液与UW液对无心跳大鼠供肝保存效果的比较  

Comparison of Celsior solution vs UW solution on preservation of livers from non-heart-beating rats

作　　者：李涛[1] 唐华美[2] 孙星[1] 裘国强[1] 王兆文[1] 彭志海[1] 

机构地区：[1]上海交通大学附属上海市第一人民医院普外科,200080 [2]上海交通大学附属上海市第一人民医院病理科,200080

出　　处：《中华器官移植杂志》2009年第6期371-374,共4页Chinese Journal of Organ Transplantation

摘　　要：目的比较Celsior（CS）液与UW液对大鼠无心跳供者（NHBD）供肝的保存效果。方法选取健康雄性SD大鼠作为肝移植的供、受者。通过阻断大鼠主动脉和膈上下腔静脉10min的方法，制备和获取NHBD供肝，并采用不同的器官保存液灌注和冷保存供肝。随机将受者分为4组。CS8h组：受者采用经CS液灌注和冷保存8h的供肝移植；UW8h组：受者采用经UW液灌注和冷保存8h的供肝移植；CS16h组：受者采用经CS液灌注和冷保存16h的供肝移植；UW16h组：受者采用经UW液灌注和冷保存16h的供肝移植。受者门静脉开放前、开放后1、3及6h，取各组受者的静脉血检测血清丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、内皮素1（ET-1）、白细胞介素1（IL-1）及肿瘤坏死因子α（TNF-α）水平；观察和比较各组受者的胆汁生成量、移植肝组织病理学改变及术后7d内的存活率。结果NHBD供肝经UW液灌注后呈“花斑”状，肝叶边缘灌注不良，经CS液灌注后肝叶边缘灌注良好。CS8h组和UW8h组受者的胆汁生成量分别为（0．21±0．01）ml和（0．10±0．02）ml（P〈0．05）。门静脉开放后1、3及6h，CS8h组受者的血清ALT及AST水平明显低于UW8h组（P〈0．05），门静脉开放后1、3h，CS8h组受者的血清ET-1、IL-1及TNF-α水平均明显低于UW8h组（P〈0．05）；CS8h组受者移植肝肝窦扩张、门静脉充血及炎症细胞浸润等病理学改变明显轻于UW8h组，CS8h组和UW8h组受者术后7d的存活率分别为58．3％和25．0％（P〈0．05）。CS16h组和UW16h组受者各时点的胆汁分泌量、血清ALT、AST、ET-1、IL-1及TNF-α水平的比较，差异均无统计学意义（P〉0．05），两组受者均在术后3d内死亡，两组受者移植肝组织病理学改变无明显差异。结论CS液对大鼠NHBD供肝的保存效果优于UW液，这可能与UW液较CS液粘稠及CS液能够减少枯否细胞的激活有关；NHBD供肝的冷Objective To compare the effects of Celsior （CS） solution vs University of Wisconsin （UW） solution on preservation of non-heart- beating donor （NHBD） livers in rats. Methods The healthy male SD rats were taken as donors and recipients. The thoracic descending aorta and supradiaphragmatic inferior vena cava were cross-clamped for 10 rain to induce ischemia as a NHBD model. After flushed with the cold CS or UW solution, NHBD livers were stored at 4℃ for 8 h or 16 h. Then they were transplanted using the two-cuff technique with arterial reconstruction. Accordingly, the recipients were divided into four groups： CS 8 h, UW 8 h, CS 16 h and UW 16 h groups. The bile discharge, liver enzymes （ALT and AST）, ET-1, ILl and TNF-alpha levels in serum at 1, 3, and 6 h after reperfusion were measured. Histopathological examination was carried out by HE staining, and the 7-day survival rate was observed. Results As compared with a homogenous appearance in the NHBD livers perfused with CS solution, the NHBD livers perfused with UW solution showed a heterogenous appearance, with more or less mottling. In the CS 8 h group there were more bile discharge at 1 h, lower ALT and AST levels at 1, 3 and 6 h, and lower serum ET-1, IL-1 and TNF-alpha ？ levels at 1 and 3 h after reperfusion than the UW 8 h group （P〈0. 05）. Histopathological examination showed a well-preserved hepatic architecture, milder portal congestion and inflammatory infiltration in CS 8 h group as compared with LIW 8 h group. The 7-day survival rate in CS 8 h and UW 8 h groups was 58. 3 % and 25.0 G respectively （P〈0. 05）. There were no significant differences in bile discharge, ALT, AST, ET-1, IL-1 and TNF-α lpha ？ levels at different time points between CS 16 h and UW 16 h groups （P〉0. 05）, and histopathological examination showed no much difference in the tissue damage between two groups; all recipients died within 3 days （P〉0. 05）. Conclusion CS was more effective than UW in preserving NHBD livers after 8 h of cold s

关 键 词：器官保存液 肝 NHBD 临床分析 

分 类 号：R686[医药卫生—骨科学]