血管冷冻保护剂的临床应用  

Clinical application of vascular cryoprotectants

作　　者：王鐥 王成 史业弘 Wang Shan;Wang Cheng;Shi Yehong(The Fifth Affiliated(Zhuhai)Hospital of Zunyi Medical University,Zhuhai 519100,Guangdong Province,China)

机构地区：[1]遵义医科大学第五附属(珠海)医院,广东省珠海市519100

出　　处：《中国组织工程研究》2023年第24期3920-3925,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:冷冻保存的同种异体血管在血管移植修复中蕴藏着广泛的临床应用前景。深低温冻存是实现同种异体血管长期保存的常用方法。在低温保存过程中,有效的冷冻保护剂对于防止血管组织低温损伤和保持细胞活力至关重要,但对于最佳保护剂的选择并未达成共识。目的:总结近年来各大血管组织库中使用的冷冻保护剂,比较其临床应用效果,以期为将来深低温冻存同种异体血管的应用提供参考。方法:由第一作者检索中国知网、万方、PubMed和Google Scholar数据库2015-2022年发表的相关文献,中文检索词为“同种异体血管,动脉,静脉,深低温冻存,冷冻保护剂,冷冻损伤,血管移植”,英文检索关键词为“cryopreservation,blood vessels,vascular allografts,arteries,veins,cryoinjury,cryoprotectants,cryoprotective agents”,检索国内外有关应用于临床的血管冷冻保护剂及其近远期结果的相关文献,最终选取54篇文献进行综述。结果与结论:(1)在血管的深低温冻存研究中,常使用包含渗透性和非渗透性的冷冻保护剂组合,通过程序性降温及快速解冻的方法减轻对血管壁结构的损伤。(2)尽管二甲基亚砜(DMSO)具有毒性作用,但在许多国家的组织库产品清单中不包括任何单独用DMSO以外的冷冻保护剂冷冻保存的心血管组织。目前深低温冻存同种异体血管用于血管移植后仍然有不少临床并发症的发生,有些甚至是致命的。(3)DMSO作为保护剂中必不可少的成分,如何平衡其毒性作用与保护效果至关重要,并且寻找安全无毒、无异种抗原的新型冷冻保护剂是目前研究的主要方向,对推动同种异体血管移植物临床应用的发展具有重要意义。BACKGROUND:Cryopreserved allogeneic blood vessels have broad clinical application prospects in vascular transplantation and repair.Cryopreservation is a common method to achieve long-term preservation of allogeneic blood vessels.During cryopreservation,effective cryoprotectants are essential to prevent vascular tissue hypothermia damage and maintain cell viability.However,there is no consensus on the choice of the best cryo protectant.OBJECTIVE:To summarize the cryoprotectants used in major vascular tissue banks in recent years and compare their clinical effects,thereby providing a reference for the application of cryo preservation of allogeneic blood vessels in the future.METHODS:The relevant literature included in CNKI,WanFang,PubMed,and Google Scholar databases from 2015 to 2022 was retrieved by the first author.The Chinese search terms were"allogeneic blood vessels,artery,vein,cryo preservation,cryoprotective agent,cryoinjury,vascular transplantation."The English search terms were"cryo preservation,blood vessels,vascular allografts,arte ries,veins,cryoinjury,cryoprotectants,c ryoprotective agents."The relevant lite rature at home and abroad on vascular cryoprotectants used in clinic and their short-term and long-term results were searched.Finally,54 articles were selected for review.RESULTS AND CONCLUSION:(1)In the study of cryo preservation of blood vessels,a combination of permeable and non-permeable cryoprotectant is often used to reduce damage to the structure of the vessel wall through programmed cooling and rapid thawing.(2)Despite the toxic effects of dimethyl sulfoxide,tissue bank product lists in many countries do not include any cardiovascular tissue cryopreserved with cryoprotectant other than dimethyl sulfoxide alone.At present,there are still many clinical complications after cryo preservation of allogeneic blood vessels for vascular transplantation,and some are even fatal.(3)As an essential component of protective agent,dimethyl sulfoxide is very important to balance its toxic effect and protect

关 键 词：同种异体血管 深低温冻存 冷冻保护剂 冷冻损伤 血管移植 移植物感染 原位重建 

分 类 号：R459.9[医药卫生—治疗学] R318.52[医药卫生—临床医学] R605