胰岛细胞移植过程中影响细胞活性的相关因素

Related factors of the activity of islets in islets transplantation

目的:探讨胰岛细胞移植过程中胰腺的切取方法、冷缺血时间、组织相容性对于胰岛细胞活性的影响。方法:实验于2001-09/2005-01在南方医科大学附属珠江医院完成。高渗枸橼酸盐嘌呤溶液经主动脉原位灌注后,探讨肝、肾、胰腺联合及分别切取情况;测定不同的冷缺血时间条件下胰岛细胞活性的变化;体外培养胰岛细胞和血液供受者的组织相容性和胰岛细胞存活的关系。结果:①对于胰腺、肾脏联合切取,肝脏、胰腺、肾脏联合切取及各器官的单独切取顺利,在冷缺血时间5h以内胰岛细胞活性率都在80%,各方法之间无明显差别。②胰腺与肾脏经高渗枸橼酸盐嘌呤溶液原位灌注满意,胰岛细胞的活性与冷缺血时间呈负相关,冷保存指数和胰岛细胞活性呈正相关。③人类胰岛暴露于未经抗凝的人类血中,胰岛将诱发一个迅速血小板激活和消耗,中性粒细胞和单核细胞也被消耗,加入肝素后这种反应明显减轻。结论:腹主动脉进行原位灌注后,用于胰岛细胞移植的胰腺和其他器官的切取不会影响胰岛细胞的活性;经高渗枸橼酸盐嘌呤溶液保存的胰腺的冷缺血时间不易超过5.0～6.0h;胰岛细胞移植入血后,都将引发血细胞的类似炎症反应;HLA配型有助于提高移植后胰岛细胞的存活。

AIM： To investigate the effects of the methods of cutting human pancreases from cadaver donors, cold ischemia preservation time and histocompatibility on the activity of islets in islets transplantation. METHODS： The experiment was carried out in the Zhujiang Hospital affiliated to Southern Medical University between September 2001 and January 2005. The hypertonic citrate adenine solution was perfused into aorta, kidney-pancreases and kidmey-pancreases-liver, were then cut together, kidney-pancreases-liver were cut respectively, and then the changes of the activity of islets under different cold ischemia preservation time were detected, the correlation between the in vitro cultured islets and blood and that between the histocompatibility of donor and the survival of islets were analyzed. RESULTS： ① The cutting of kidney, pancreases and liver were kilter. If the cold isehemia preservation time within 5 hour, the activity of islets may be about 80%. Activity of islets and the cold isehemia preservation time was in a negative correlation when human islets were exposed to nonanticoagulatod human blood, it would induce a rapid consumption of platelets, neutrophils, monocytes and lymphocytes in the blood. When heparin was added to the blood, these events were avoided. After cultivates 24 hours, the quantity of living islets in HLA typing compatible groups is more than the groups which HLA typing was incompatibility. CONCLUSION： With the hypertonic citrate adenine solution was perfused into aorta, the methods of cutting human pancreases from cadaver donors for islets transplantation have nothing infected activity of islets. The cold isehe, mia preservation time of the pancreases preserved in hypertonic citrate adenine solution is better not more than 5.0-6.0 hours. When human islets were exposed to human blood, a series of inflammatory events were found to occur, HLA typing will conduce to enhance the quantity of living islets.