这项研究调查了在猪肝移植模型中,缺血后处理(IPO)是否改善了心脏死亡后供体器官的结局,并与低温机器灌注(HMP)具有协同作用。
在48只健康巴马小型猪中建立心脏死亡后供体(DCD)模型,随机分为4组:简单冷藏组(SCS组),IPO集团,HMP组,HMP-IPO集团。血清谷丙转氨酶(ALT)水平,总胆红素,组织病理学发现,肝细胞凋亡活性,国际标准化比率(INR),肿瘤坏死因子-α(TNF-α),与丙二醛(MDA)进行比较。
SCS组所有受者在移植后6小时内死亡。IPO中的接受者的肝脏在第5天有50%的存活率。HMP允许83.3%存活,HMP-IPO允许100%存活。再灌注后,IPO和HMP-IPO组的接受者ALT和总胆红素水平较低,铃木得分较少,更少的细胞凋亡,肝细胞和胆管损伤较小,炎症反应和氧化负荷减弱。
在猪肝移植模型中,IPO改善了心脏死亡后供体器官的结局,并与HMP具有协同作用。
This study investigated whether ischemic postconditioning (IPO) improved the outcome of organs from donors after cardiac death and had a synergistic effect with hypothermic machine perfusion (
HMP) in a pig liver transplantation model.
A donor after cardiac death (DCD) model was developed in 48 healthy Bama miniature pigs randomly divided into four groups: simple cold storage group (SCS group), IPO group,
HMP group,
HMP-IPO group. The levels of serum alanine aminotransferase (ALT), total bilirubin, histopathological findings, apoptotic activity of hepatocytes, international normalized ratio (INR), tumor necrosis factor-α (TNF-α), and Malondialdehyde (MDA) were compared.
All recipients in the SCS group died within 6 h after transplantation. The livers of the recipients in the IPO had 50% survival on day 5.
HMP allowed 83.3% survival and
HMP-IPO allowed 100% survival. After reperfusion, the recipients in the IPO and
HMP-IPO group had lower ALT and total bilirubin levels, less Suzuki score, less apoptosis, and less injury to hepatocytes and biliary ducts and attenuated inflammatory response and oxidative load.
IPO improved the outcome of organs from donors after cardiac death and had a synergistic effect with HMP in the pig liver transplantation model.