猪肝脏常温机械灌注系统的建立和改良

Establishment and modification of normothermic machine perfusion system for porcine liver

目的探讨常温机械灌注系统在离体猪肝脏保存中的可操作性、安全性及有效性。方法使用雄性中国长白猪获取供肝，利用常温机械灌注系统灌注6h，研究肝脏的血流动力学、血气生化指标及组织学变化。结果猪肝脏经6h常温机械灌注，肝动脉流量（293±23）ml／min，肝动脉压力（66．9±3．6）mmHg（1mmHg=0．133kPa）；门静脉流量（885±65）ml／min，门静脉压力（6．1±0．6）mmHg；胆汁分泌（10．5±1．1）rnl／h。pH7．5±0．1，血糖（6．9±0．8）mmol/L；ALT（47．4±9．1）U／L，AST（765．1±137．6）U／L。病理显示肝小叶结构完整，无严重的细胞结构破坏，肝脏病理损伤的Suzuki评分3．2±0．2。结论我们建立的改良常温机械灌注系统能维持离体猪肝的生理状态，其操作简便、安全，为后续修复边缘性供肝提供了良好的平台。

Objective To investigate the operability-, security and availability of an improved nor- mothermic machine perfusion system in the process of extracorporal porcine liver preservation. Methods Livers from Chinese male Landraces were perfused using the improved normothermic machine perfusion sys- tem for 6 hours. Haemodynamies, blood gas, biochemical markers and histology were detected. Results After 6-hour normothermie machine perfusion, the flow of hepatic artery and portal vein were （ 293 _＋ 23 ） ml/min and 885 ＋ 65 ml/min, respectively. The hepatic arterial pressure was （66.9 -＋ 3.6） mmHg and the portal pressure was （6.1 ＋0.6） mmHg. Bile generation was （ 10.5 _＋ 1.1 ） ml/h. pH was 7.5 _＋0.1. Glu- cose level decreased to （6.9 _＋0.8） mmol/L. ALT was （47.4 _＋9.1 ） U/L and AST was （765.1 _＋ 137.6） U/L. Histological architecture remained intact without any unrecoverable injury and the Suzuki score was 3.2 ＋ 0. 2 after perfusion. Conclusions The physiological condition of the extracorporal porcine livers can be maintained by the improved normothermie machine perfusion system with excellent operability and securi- ty. This system can provide a promising platform for repairing and resuscitating marginal livers, which could further expand the donor pool.