供肝冷热缺血移植后损伤与炎症细胞的关系

Whether the impairment of grafted liver was induced by the inflammatory cells in cold and warm ischemia after transplantation

目的 探讨冷、热缺血移植术后引起供肝损伤的炎性细胞是否相同。方法 雄性SD大鼠随机分成2组,每组各24只。供肝分别在乳酸林格氏中保存120或240min后行原位肝移植术;另雄性SD大鼠随机分成3组,每组各24只供肝分别经心跳停搏90、120和150min后行原位肝移植术。大鼠分别于术后1、3、6和24h处死采样。结果 随着冷、热缺血时间的延长,移植后血清ALT等值不断升高,如冷缺血120min和240min移植术后1h ALT值(U/L)分别为454.8±45.2和1063.0±166.1,3h分别为712.0±65.9和1639.0±241.2,6h分别为1702.0±169.2和4193.0±672.7,24h分别为1067.0±141.2和1316.7±205.2,热缺血90、120和150min移植术后1hALT值(U/L)分别为5035.2±786.7、6075.3±1613.1和 7449.5±1052.0,3h分别为5564.5±696、4、7900.7±863.0和8854.8±2089.3,6h分别为7363.8±616.7、10459.3±1573.7和10294.0±530.0,24h90min组为1942.5±188.5;且术后移植肝的病理损害也逐渐加重。冷缺血移植术后3、6h肝细胞出现坏死,且有大量中性粒细胞浸润;热缺血移植术后3、6h肝细胞也有大量坏死,但却出现淋巴细胞趋润。电镜表现与镜下基本一致,旦电镜证实热缺血移植后浸润的淋巴细胞为T淋巴细胞。结论 冷、热缺血移植术后供肝的损伤似乎是由两种不同的炎性?

Objective To investigate whether the impairment of grafted liver after transplantation was induced by the same inflammatory cells in cold and warm ischemia. Methods Male SD rats were divided into two groups randomly, 24 grafted livers in each group were stored for 120 or 240 min at 4'C Ringer's solution. Also male SD rats were divided into three groups, in which 24 grafted livers in each group were experienced warm ischemia ranged from 90, 120 to 150 min from non-heart-beating donor. The recipients were killed after 1, 3, 6, and 24 h of transplantation for sample collection. Results Along with the prolongation of cold and warm ischemia time, the serum ALT and AST levels were increased gradually after transplantation. Light microscopy showed some necroses in hepatocytes after 3 and 6 h of transplantation in cold ischemia, and some neutrophilic infiltration in sinusoids. There were a large number of hepatocytes necroses after 3,6 h of transplantation in warm ischemia from non-heart-beating donor and a lot of lymphocytic infiltration in sinusoids. The findings in electron microscopy were as the same as those found in light microscopy, and the lymphocytes which infiltrated in sinusoids in warm ischemia were identified as T lymphocytes in electron microscopy. Conclusions The impairment of grafted livers after transplantation seems to be induced by two different inflammatory cells in cold and warm ischemia, that is, neutrophils mediate the cold ischemia-reperfusion, and T lymphocytes mediate the warm ischemia-reperfusion from non-heart-beating donor.