机器灌注保存供肝在大鼠肝移植中的实验研究

Machine perfusion for preservation of liver donors in liver transplantation: an experimental study in rats

目的观察机器灌注保存供肝在肝脏移植中的应用效果,探讨机器灌注保存供肝的作用机制。方法将大鼠供肝行机器灌注保存,然后行原位肝移植。于术后4h,检测受体血清中丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、乳酸脱氢酶(LDH)、血清总胆红素、透明质酸的浓度;光镜下观察肝细胞及肝窦内皮细胞的形态学改变。结果机器灌注组ALT、AST、LDH、血清总胆红素、透明质酸均显著低于对照组(P<0.05)。实验组各保存时相肝细胞及肝窦内皮细胞肿胀、变性和坏死程度均明显轻于同时相对照组。结论机器灌注保存方法对离体肝脏的肝细胞、肝窦内皮细胞有保护作用,移植术后肝功能恢复良好;在保存液、保存温度相同的情况下,机器灌注保存方法在肝功能保护、延长保存时间方面都优于低温缺血保存方法。

Objective To observe the benefits and mechanisms of machine perfusion （MP） for preservation of liver donors. Methods Entopic transplantations were performed using MP-preserved rat liver donors. Serum samples of all recipients were collected at the 4 hours after transplantation and tested for the levels of alanine aminotransferase （ALT）, aspartate amino transferase （AST）, lactate dehydrogenase （LDH）, serum total bilirubin （STB） and hyaluronic acid （HA）. Morphological changes of hepatocytes and sinusoidal endothelial cells were studied under light microscope. Re- suits The values of serum ALT, AST, LDH, STB and HA were significantly lower in MP group than in control group （cold storage, CS） （P〈0.05）. The morphological changes, such as edema, degeneration and necrosis of hepatocytes and sinusoidal endothelial cells, were significantly milder in MP group than in control group. Conclusion MP provided better protection for hepatocytes and sinusoidal endothelial cells of liver donors and resulted in more favorable post-procedural restoration of liver function. Given the same conditions of solution and temperature, MP may have advantages over CS in terms of better and longer protection.