常温机械灌注保存对DCD小型猪脂肪肝供肝的影响  

Effect of normothemic machine perfusion on preserving fatty liver graft in mini-porcines DCD model

作　　者：郑飞波[1,3] 谢炎 张骊 陈池义[2,3] 孙纪三 史源[4] 郭庆军 蒋文涛 ZHENG Fei-bo;XIE Yan;ZHANG Li(Department of Surgery,Tianjin Occupational Diseases Precaution and Therapeutic Hospital,Tianjin 300011,China)

机构地区：[1]天津市职业病防治院(工人医院)外科,天津300011 [2]天津市第一中心医院肝移植科,天津300192 [3]天津医科大学一中心临床学院,天津300070 [4]天津市器官移植重点实验室,天津300100

出　　处：《肝胆外科杂志》2022年第1期69-72,共4页Journal of Hepatobiliary Surgery

基　　金：国家自然科学基金面上项目(81870444);天津市自然科学基金(19JCQNJC10300)。

摘　　要：目的探讨应用常温机械灌注装置保存对DCD小型猪脂肪肝的降脂及修复作用.方法选取巴马小型猪4只,建立脂肪肝猪DCD及热缺血时间30main动物模型后,切取肝脏约5cm×5cm放入UW液冷藏保存(SCS组),余放入常温机械灌注装置中进行灌注保存(NMP组).在保存开始后2h、4h、6h分别切取肝组织进行肝匀浆质脂质含量检测,观察两组肝脏病理组织学变化.结果经6h保存,NMP组和SCS组肝匀浆质脂质含量无显著差异(t,P值分别为CHO:2.315,0.0947;TG:2.620,0.0511);NMP组保存6h肝匀浆质CHO、TG水平较0h明显降低(P<0.05),SCS组保存6h肝匀浆质CHO、TG较0h差异均无统计学意义(P>0.05).不同保存时间SCS组和NMP组肝脏组织病理比较:SCS组在冷保存6h过程中,肝窦淤血有所加重,肝脏脂肪变程度无明显变化;NMP组在开始灌注后2h,中央静脉及肝窦广泛淤血,后逐渐减轻,肝脏脂肪变程度亦逐渐减轻.结论通过NMP保存小型猪脂肪肝供肝能减轻肝脏脂质蓄积,避免肝细胞随保存时间延长而损伤,进而使供肝能得到一定程度修复,有效改善边缘供肝质量.Objective To investigate the effect of normothermic machine perfusion(NMP)device on lipid-lowering and repairing of fatty liver grafts from mini-porcines DCD model.Methods Pour Bama mini-porcines were selected to build fatty liver animal model.Keep warm ischemic time at 30 minutes,then one piece(5cm x5cm)of liver graft was removed and placed in UW solution for cold storage(SCS group),meanwhile the rest of liver was preserved in normothermic perfusion machine(NMP group).Cholesterol(CHO)and Triglyceride(TG)in liver homogenate were examined,and pathological analysis was detected for each group at 2h,4h and 6h after preserving.Results No significant difference was shown in the level of CHO and TG(t,P:CHO:2.315,0.0947;TG:2.620,0.0511)between two groups through 6h preservation.The level of CHO and TG was significantly decreased in NMP group(P<0.05),however they did not reach statistical significance(P>0.05)in SCS group.Comparison of biopsy results between NMP and SCS group at different time-points:In SCS group,hepatic sinus congestion was increased in a certain level,and there was no difference about the degree of steatosis in the process of cold storage for6h;In NMP group,central vein and hepatic sinus showed extensive congestion after 2h preservation,then they gradually reduced as well as the degree of steatosis.Conclusions NMP can relieve the degree of hepatic lipid accumulation,prevent hepatocyte impairment after long time preservation,as well as repair the liver graft and promote the condition of marginal graft.

关 键 词：机械灌注 器官保存 脂肪肝 猪 动物模型 

分 类 号：R578[医药卫生—消化系统]