猪肝移植时无心跳供体耐受热缺血时间的实验研究

Time limits of tolerance to warm ischemia of liver grafts from NHBD in pigs

目的探讨心脏停搏供体猪肝移植时供肝耐受无心跳热缺血损伤的安全时限。方法建立小型猪原位肝移植动物模型并按移植前供肝经历心脏停搏时间0,15,30,45 min分为四组。观测肝移植术后各组肝功能、肝脏病理和肝脏能量代谢改变。结果肝脏能量代谢等指标的改变在供肝无心跳热缺血时间30 min前是可逆的,随无心跳热缺血时间的延长逐渐向不可逆演变。结论在本实验条件下,小型猪心脏停搏供体肝移植时供肝耐受无心跳热缺血损伤的安全时限约为30min。

Objective To investigate the safe duration limits of tolerance to warm ischemia of liver grafts from non-heart-beating donor（NHBD） in pigs. Methods Small pig orthotopic liver transplantation was performed in 4 groups with 0,15,30 and 45 min cardiac arrest time in the donors. Pathological observation, function, energy metabolism of liver after reperfusion were compared. Results The viability of energy metabolism of liver was reversible before 30 min cardiac arrest time in donors, but it turned irreversible with the prolong of the cardiac arrest time in donors. Conclusion The safe duration limits of tolerance to warm iscbemia of liver grafts from NHBD in pigs is about 30 min.