兔肝冷保存后复温缺血-再灌注损伤及其相关机制的研究

摘要

目的:探讨原位肝移植过程中供肝冷保存后复温缺血-再灌注损伤的意义及其相关机制。方法:采用兔肝冷保存-再灌注损伤模型，观察兔肝冷保存后复温缺血对其再灌注后肝功能的影响及在此过程中肝组织内丙二醛(MDA)含量及超氧化物歧化酶(SOD)活性的变化。结果:冷保存6h后又分别经历0、15、30及60min复温缺血的4组供肝于再灌注2h时，复温缺血时间越长者，其受体兔血液中AST、ALT或AKP值越大；且各组彼此间均存在非常显著差异（P＜0.01）。此外，各组供肝在复温缺血末及再灌注2h时，组织中SOD活性或MDA含量彼此间也均有非常显著差异（P＜0.01）;且复温缺血时间越长的供肝组织中SOD活性越低，而MDA含量则越高。结论:兔肝冷保存后即使经历一短暂的复温缺血也会给其再灌注后的肝功能带来显著损伤，且氧自由基及其引发的脂质过氧化反应参与了兔肝复温缺血-再灌注损伤过程;提示供肝冷保存后复温缺血可能是导致肝移植术后原发性供肝功能损伤的重要原因。%AIM： To explore the value of donor liver re-warmischemia-reperfusion injury during orthotopic liver transplantation and its mechanism. METHODS: The effect of rabbit liver re-warm ischemia on its reperfused liver function and change of malondialdehyde(MDA) and superoxide dismutase(SOD) in the hepatic tissue were observed with rabbit liver preservation-reperfusion injury model . RESULTS： In every group of donor livers, which had experienced re-warm ischemia for 0, 15, 30 and 60 minutes respectively following 6-hours cold storage,the more prolonged re-warm ischemia was, the higher the contents of blood AST, ALT and AKP of receptor rabbits would be, and among all the groups there was significant difference in the contents of AST or ALT or AKP(P＜0.01). Besides, the more prolonged re-warm ischemia was, the more SOD activities were decreased and more MDA contents were increased.There was significant difference in SOD activities or MDA contents among all groups (P＜0.01). CONCLUSION: A short re-warm ischemia of the rabbit liver may cause a significant injury on its reperfused liver function. Meanwhile , oxgen free radicals and its lipid peroxidation reaction mediated the pathological changes of the rabbit liver re-warm ischemia-reperfusion injury. It was indicated that the donor liver re-warm ischemia may play an important role in primary liver function injury of post-transplantation.