不同胆道灌洗方法对供肝胆道冷保存损伤的影响

Effects of different method of bile ducts perfusing on cold preservation injury to donor bile ducts

目的 探讨不同胆道灌洗方法对供肝胆道冷保存的影响。方法 将经历相同热缺血时间的SD大鼠肝脏用 4℃UW液 (solutionofuniversityofsiscolnsin)门静脉灌注后 ,分为胆道非灌洗组、4℃生理盐水灌洗组、4℃UW液灌洗组、4℃生理盐水 +UW液灌洗组 ,分别置于 4℃UW液中保存 ,光镜观察胆道粘膜。结果 非灌洗组胆道损伤明显 ,生理盐水组存在一定程度的胆道损伤 ,4℃生理盐水 +UW液组胆道保护效果理想 ,4℃UW液逆行灌洗组次之。结论 ①肝脏冷保存前必须进行胆道灌洗 ,避免残留胆汁对胆道损伤 ;②冷保存前胆道灌洗可以明显减轻胆道损伤 ;③不同胆道灌洗方法中采用 4℃生理盐水灌洗

Objective To explore the effects of bile duct perfusing in different methods on the cold preservation injury to donor bile ducts in different method of bile ducts perfusing. Methods The livers from SD rats was perfused with 4 ℃ UW solution via portal vein after same ischemic time, then divided into various groups: control group (group A) without bile ducts perfusing, bile ducts in group B were perfused with 4 ℃ saline, group C perfused with 4 ℃ UW solution, group D perfused with 4 ℃ saline and UW solution. The liver graft was stored in 4 ℃ UW solution, the bile ducts mucous membrane was observed under light microscope. Results The injury observed in control group was obvious, perfused with saline was milder. The best beneficial effect to bile ducts was achieved when perfused with 4 ℃ saline and UW solution, perfusing with 4 ℃ UW solution is the second choice. Conclusions To avoid the bile ducts injury from remnant bile, donor bile ducts should be perfused before preservation and the best way is to perfuse with 4 ℃ saline and UW solution via bile ducts.