大鼠原位肝移植后微循环障碍及前列腺素E_1对其保护作用的实验研究

Experimental research on rat liver microcirculation disturbance following orthotopic liver transplantation and the protective effect of PGE_1

目的研究大鼠肝脏微循环变化及 PGE_1对其的作用,同时观察血清酶 ALT、LDH 变化及超微结构变化。方法通过供肝切取前静脉输注前列腺素 E_1(PGE_1)(0.5μg/kg/min)及灌洗保存液中加入 PGE_1(1mg/L),以三袖套法建立大鼠原位肝移植模型,共焦激光扫描活体显微镜技术,生化检测技术、透射电镜技术。结果 1.移植再灌注后,鼠肝微循环紊乱,部分小叶无灌注,肝窦内可见大量白细胞粘附;实验组则好于对照组;实验组灌注指数及灌流率分别高于对照组(P<0.05)。2.移植后血清 ALT、LDH 升高,实验组较对照组有明显降低。(P<0.05)。3.实验组电镜下的形态学改变明显轻于对照组。结论肝移植过程中,缺血再灌注损伤可造成肝脏微循环紊乱,是供肝失活的一个重要原因。供体肝脏切取前静脉应用 PGE_1及灌洗保存液中加入 PGE_1能改善肝脏微循环,减轻缺血再灌注损伤,对供肝有保护作用。

Objective To determine the effect of PGE_1 on the liver microcirculation disturbance following orthotopie liver transplantation in rats.Methods PGE_1 was injected intravenously to donors before removal of the liver at a dosage of 0.5μg/kg body weight/min as well as adding into the flushout and preservation fluid at a concentration of 1mg/L.Confoeal laser scan microscopy,biochemical tests, and electron microscopy were used.Results The reperfusion state of the control group was poor and leukocyte infiltration appeared in the center of lobule following transplantation.Transaminase rose up after transplantation.Ultrastruetural findings showed progressive degeneration and necrosis occurred following transplantaion.Distinctive improvement could be seen in the experimental group as compared with the control group by the use of PGE_1.Conclusion In the process of liver transplantation,the is- chemia reperfusion damage may lead to hepatic microcirculation disturbance,which is a major cause of graft failure.Intravenous infusion of PGE_1 into donor liver preisehemia and adding PGE_1 into the cold storage fluid could improve the hepatic microcirculation,leading to reduction of the ischemic reperfusion damage,therefore,are protective in liver transplantation.