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Safe time to warm ischemia and posttransplant survival of liver graft from non-heart-beating donors

机译:非心跳供体温暖缺血和移植肝存活的安全时间

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摘要

AIM: To explore the dynamical changes of histology, histochemistry, energy metabolism, liver microcirculation, liver function and posttransplant survival of liver graft in rats under different warm ischemia times (WIT) and predict the maximum limitation of liver graft to warm ischemia.METHODS: According to WIT, the rats were randomized into 7 groups, with WIT of 0, 10, 15, 20, 30, 45, 60 min, respectively. The recovery changes of above-mentioned indices were observed or measured after liver transplantation. The graft survival and postoperative complications in each subgroup were analyzed.RESULTS: Liver graft injury was reversible and gradually resumed normal structure and function after reperfusion when WIT was less than 30 min. In terms of graft survival, there was no significant difference between subgroups within 30 min WIT. When WIT was prolonged to 45 min, the recipients’ long-term survival was severely insulted, and both function and histological structure of liver graft developed irreversible damage when WIT was prolonged to 60 min.CONCLUSION: The present study indicates that rat liver graft can be safely subjected to warm ischemia within 30 min. The levels of ATP, energy charge, activities of glycogen, enzyme-histochemistry of liver graft and its recovery potency after reperfusion may serve as the important criteria to evaluate the quality of liver graft.
机译:目的:探讨不同热缺血时间(WIT)大鼠肝移植组织学,组织化学,能量代谢,肝微循环,肝功能和移植后存活的动态变化,并预测肝移植对热缺血的最大局限性。根据WIT,将大鼠随机分为7组,WIT分别为0、10、15、20、30、45、60分钟。肝移植后观察或测量上述指标的恢复变化。结果:当WIT少于30 min时,肝移植损伤是可逆的,并在再灌注后逐渐恢复正常的结构和功能。就移植物存活而言,WIT 30分钟内各亚组之间无显着差异。当WIT延长至45 min时,会严重损害受体的长期存活,而当WIT延长至60 min时,肝移植的功能和组织学结构均会发生不可逆的损伤。结论:本研究表明大鼠肝移植可以在30分钟内安全地经受温暖的局部缺血。 ATP水平,能量电荷,糖原活性,肝移植物的酶组织化学及其在再灌注后的恢复能力可能是评估肝移植物质量的重要标准。

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