灌注速度对移植肝脏缺血再灌注的损伤  

Effects of perfusion speed on graft ischemia/reperfusion injury following liver transplantation

作　　者：肖宏[1] 尹思能[1] 陈安平[1] 田刚[1] 陈先林[1] 龙飞伍[1] 

机构地区：[1]成都市第二人民医院肝胆胰外科,四川省成都市610017

出　　处：《中国组织工程研究与临床康复》2011年第5期788-791,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：四川省卫生厅科研基金项目(080015;090025)~~

摘　　要：背景:近年来有学者研究发现供体灌注的压力可直接影响移植物的能量代谢从而影响其活力,适当的灌注压力能明显提高供体的质量。目的:观察不同灌注速度对大鼠移植肝脏再灌注损伤的影响。方法:采用改良的Kamada双袖套法建立SD→SD原位肝移植模型。供体肝脏获取时分别以50,100,150,200mL/h进行灌注。检测移植后外周血清肿瘤坏死因子α和谷丙转氨酶水平,观察肝脏组织病理学改变和肝脏组织内皮源性一氧化氮合酶的表达变化。结果与结论:与低灌注速度相比,供体肝脏制备过程中200mL/h的灌注速度导致了更加明显的肝脏病理形态学改变,肝细胞变性、肝血窦扩张和炎细胞浸润也更加明显。术后24h肝功能的检测也发现,150,200mL/h灌注速度组外周血谷丙转氨酶活性、肿瘤坏死因子水平明显高于50,100mL/h灌注速度组(P<0.05,P<0.01),内皮源性一氧化氮合酶表达明显低于50,100mL/h灌注速度组(P<0.01),100mL/h灌注速度后,随着灌注速度的增加肝功能损伤也明显加重。证实适当的灌注压力和速度是获得高质量供体的保障,能够减轻移植后肝功能损伤,改善受体预后,在大鼠肝移植供体制备过程中100mL/h是适宜的灌注速度。BACKGROUND：Previous studies demonstrated that perfusion pressure influences the energy metabolism of graft and affects its energy,suitable perfusion pressure can significantly improve the quality of donor. OBJECTIVE：To investigate the effects of various perfusion-speeds on reperfusion injury of graft after rat orthotopic liver transplantation. METHODS：SD to SD rat orthotopic liver transplantation models were established by improved Kamada two-cuff technique. Perfusion-speed during harvesting grafts was 50,100,150 and 200 mL/h,respectively. The morphological change of grafts were observed by light microscope,alanine transarninase （ALT） and tumor necrosis factor-α （TNF-α） in peripheral serum and endothelial nitric oxide synthase （eNOS） protein and mRNA intragraft were detected. RESULTS AND CONCLUSION：The pathohistological damage of grafts in 200 mL/h group was obviously compared with other groups. Compared with 50 and 100 mL/h groups,ALT in 150 and 200 mL/h groups was significantly decreased （P 0.05,P 0.01）,but the expression of eNOS protein and mRNA was obviously lower （P 0.01）. The hepatic function damaged seriously with increasing of perfusion speed after 100 mL/h. The findings demonstrated that suitable perfusion speed can reduce hepatic function injury and improve prognosis. 100 mL/h was compatible speed for harvesting graft of rat liver transplantation.

关 键 词：灌注速度 肝移植 缺血再灌注损伤 大鼠 器官移植 

分 类 号：R617[医药卫生—外科学]