在体常温局部灌注对猪心死亡供体肝脏的修复作用  

The effect of in vivo local normothermic perfusion in vivo on the repair of liver in donation after cardiac death porcine livers

作　　者：李鹏 谭晓宇 雷志斌 陈耀 王春政 何锡然 邝伟键 郭家钘 陈素平 欧阳青 何洹 陈建雄 林炎志 霍枫 Li Peng;Tan Xiaoyu;Lei Zhibin;Chen Yao;Wang Chunzheng;He Xiran;Kuang Weijian;Guo Jiaxian;Chen Suping;Ouyang Qing;He Huan;Chen Jianxiong;Lin yanzhi;Huo Feng(Guangdong Shunde Industrial Design Institute(Guangdong Shunde Innovation Design Institute),Foshan 528311,Guangdong,China;Hepatobiliary surgery of Southern Theater General Hospital,Guangzhou 510010,Guangdong,China)

机构地区：[1]广东顺德工业设计研究院(广东顺德创新设计研究院),广东佛山5283111 [2]中国人民解放军南部战区总医院肝胆外科与肝移植中心,广东广州510010

出　　处：《实用器官移植电子杂志》2020年第4期256-260,共5页Practical Journal of Organ Transplantation(Electronic Version)

基　　金：公民心死亡器官捐献移植体系建设及关键技术研究(2012A030400023);军队实验动物专项科研项目〔SYDW(2017)12〕;国家青年科学基金项目(81800556);广东省基础与应用基础研究基金项目(2020A1515010557);佛山顺德区重大科技计划项目“离体肝脏机械灌注系统研发项目”〔顺府办函(2019)42号〕;广东省自然科学基金面上项目(2020A151501561);广州市基础与应用基础研究项目(202002030201)。

摘　　要：目的探讨在体常温局部灌注对猪心脏死亡器官捐献(donation after cardiac death,DCD)肝脏的修复作用。方法45 kg巴马小型猪(n=3)在麻醉后,分别经颈静脉、髂动脉插入导管并与体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)连接。静脉注射氯化钾溶液引发心跳骤停,30 min后置入球囊导管阻断胸主动脉,开始运转设备进行在体常温(37℃)局部灌注4 h,静脉血氧维持在60%~70%,每隔1 h检测其血气、生化指标,灌注前、后取肝脏组织,进行病理观察。结果4 h灌注过程中,设备运转稳定,乳酸显著下降(P<0.05),肝脏持续有胆汁生成,丙氨酸转氨酶、谷氨酰转肽酶及总胆红素浓度变化无统计学差异(P>0.05),天冬氨酸转氨酶在正常范围内,病理切片提示灌注前、后的病理评分差异极其显著(P<0.01)。结论本研究证明在体常温局部灌注对猪DCD 30 min肝脏具有修复作用。Objective To explore the effect of local normothermic perfusion on the repair of donation after cardiac death porcine livers.Methods 45 kg Bama minipigs(n=3)were used in V-A extracorporeal membrane oxygenation(ECMO)perfusion after anesthesia.The devices were drained from the jugular vein,perfused through the iliac artery,and the balloon blocked the thoracic aorta,the device was started after 30 min of cardiac arrest at the temperature of 37℃.The venous blood oxygen saturation was maintained between 60%and 70%by adjusting the flow rate of circle blood in 4 h of machine perfution.Blood gas and biochemical parameters were detected every hour.Liver tissue was obtained before and after perfusion for H&E staining.Results During the 4 h perfusion,the equipment operated stably.Lactic acid was decreased significantly(P<0.05),and bile was produced all the time.The alanine aminotransferase,glutamyl transpeptidase and total bilirubin were not significantly different(P>0.05),aspartate aminotransferase concentration in the normal range.The pathological scores were extremely significance different between before and after perfusion(P<0.01).Conclusion This study proved that local normothermic perfusion can repair the DCD porcine livers with 30 cardiac arrest.

关 键 词：在体机械灌注设备 心死亡供体 肝脏修复 

分 类 号：R657.3[医药卫生—外科学]