自体猪血体外常温持续灌流离体肝脏的可行性分析  

Feasibility of continuous extracorporeal normothermic liver perfusion using autologous blood:a study in pigs

作　　者：向开敏[1] 禹华旭[2] 袁金忠 李征[4] 

机构地区：[1]中南大学湘雅三医院普外科,湖南长沙410013 [2]长沙医学院湖南省重点建设学科,湖南长沙410013 [3]湘雅移植医学研究院,湖南长沙410219 [4]中南大学肿瘤研究所,湖南长沙410013

出　　处：《南方医科大学学报》2014年第2期223-227,共5页Journal of Southern Medical University

基　　金：国家自然科学基金(81171132);湖南省自然科学基金(04JJ6017);湖南省教育厅重点课题(10A013);湖南省重点学科建设经费资助(湘教发2011-76号)~~

摘　　要：目的研究体外闭合环路内自体猪血常温血液持续循环灌注器官96 h并维持较好结构和功能状态的可行性。方法 8个猪肝脏分别在体外闭合管路内用自体猪血灌注,均持续96 h。实验中需行切肝、低温保存、静脉置管、常温灌注、血液氧合。通过代谢、合成、血流动力学、组织学参数来评价实验中猪肝的活力。结果经过96 h自体猪血常温血液体外灌注之后,体外肝脏维持了正常生理水平的pH和电解质,肝脏合成功能(补体和V因子)持续存在。血流动力学参数保持在正常生理范围内。组织学检查显示肝脏细微和整体结构保存完好。结论自体猪血体外灌注离体肝脏96 h并维持较好的存活状态是可行的。Objective To study the feasibility of sustaining the viable status of a liver graft in at least 96 h by extracorporeal perfusion using autologous blood. Methods Eight extracorporeal porcine liver perfusions using autologous blood were performed, each for 96 h with hepatectomy, cold preservation, cannulation of vessels, and initiation of perfusion with normothermic oxygenated porcine blood. The graft viability was assessed by metabolic, synthetic, hemodynamic, and histologic parameters. Results After 96 h of normothermic, extracorporeal perfusion using autologous blood, the isolated livers maintained normal physiological levels of pH and electrolytes with sustained hepatic protein synthesis （complement and factor V） throughout the perfusion. Hemodynamic parameters maintained normal physiological ranges. Histological inspection demonstrated good preservation of the liver with a good architectural integrity. Conclusion It is possible to sustain the viable status of a liver graft within 96 h by extracorporeal perfusion using autologous blood.

关 键 词：猪肝 自体血 体外灌流 肝衰竭 器官保存 

分 类 号：R657.3[医药卫生—外科学]