留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

机械灌注与单纯冷保存对猪DCD供胰影响的对比研究

富大智 程颖 刘永锋

富大智, 程颖, 刘永锋. 机械灌注与单纯冷保存对猪DCD供胰影响的对比研究[J]. 器官移植, 2015, 6(5): 307-310, 315. doi: 10.3969/j.issn.1674-7445.2015.05.006
引用本文: 富大智, 程颖, 刘永锋. 机械灌注与单纯冷保存对猪DCD供胰影响的对比研究[J]. 器官移植, 2015, 6(5): 307-310, 315. doi: 10.3969/j.issn.1674-7445.2015.05.006
Fu Dazhi, Cheng Ying, Liu Yongfeng. Comparative study of effect of mechanical perfusion and simple cold preservation on DCD pancreas in pigs[J]. ORGAN TRANSPLANTATION, 2015, 6(5): 307-310, 315. doi: 10.3969/j.issn.1674-7445.2015.05.006
Citation: Fu Dazhi, Cheng Ying, Liu Yongfeng. Comparative study of effect of mechanical perfusion and simple cold preservation on DCD pancreas in pigs[J]. ORGAN TRANSPLANTATION, 2015, 6(5): 307-310, 315. doi: 10.3969/j.issn.1674-7445.2015.05.006

机械灌注与单纯冷保存对猪DCD供胰影响的对比研究

doi: 10.3969/j.issn.1674-7445.2015.05.006
基金项目: 

公益性行业科研专项 201302009

详细信息
  • 中图分类号: R617

Comparative study of effect of mechanical perfusion and simple cold preservation on DCD pancreas in pigs

More Information
  • 摘要:   目的  对比研究机械灌注与单纯冷保存对猪心脏死亡器官捐献(DCD)供胰的影响。  方法  健康猪10只, 随机分为单纯冷保存组和机械灌注组两组(每组各5只)。制备DCD猪模型, 胰腺切取后采用威斯康星大学保存液(UW液)保存。单纯冷保存组给予单纯UW液冷保存, 机械灌注组给予机械灌注保存。分别于保存1、2、3、4、6、24 h时点在胰尾部取材, 制作组织切片, 予苏木素-伊红(HE)染色。两组进行胰腺组织病理学检查, 并对病理学评分进行比较。  结果  猪DCD供胰在机械灌注180 min时胰腺微血栓已被清除, 又避免了过度灌注对胰岛的损害。机械灌注组病理学评分为(4.2±0.8)分, 单纯冷保存组病理学评分为(8.4±1.1)分, 比较差异有统计学意义(P < 0.05)。  结论  机械灌注可以有效清除胰腺血管内血栓。与单纯冷保存比较, 保存相同时间后, 机械灌注组更能维持胰岛的完整性。

     

  • 图  1  两组杂交猪DCD模型胰腺组织在不同保存时间的病理学变化

    注:保存1 h,无论单纯冷保存组(A、B图)还是机械灌注组(C、D图),其叶间血管的红细胞开始聚集,形成血栓;保存2 h,单纯冷保存组(E、F图)变化不大,机械灌注组(G、H图)随着机械灌注的进行,叶间血管内红细胞已经清除,毛细血管内仍有红细胞存在;保存3 h,与单纯冷保存组(I、J图)比较,机械灌注组(K、L图)胰岛形态完整,而且血栓完全被清除;保存4 h,机械灌注组(O、P图)胰岛开始出现水肿、部分破坏,但单纯冷保存组(M、N图)胰岛破坏更为严重;保存24 h,单纯冷保存组(Q、R图)胰腺细胞已失去正常形态,机械灌注组(S、V图)胰岛也破坏明显

    Figure  1.  The pathologic changes of pancreatic tissue of cross bleeding pigs of DCD model in two groups at different preservation 13:21:14

    表  1  胰腺组织切片病理检查项目及评分要求

    Table  1.   The pathologic examination items and grade criterion of pancreatic tissue sections

    分级(评分) 腺泡细胞 胰岛 炎症反应 水肿
    0级(0分) 无破坏 胰岛完整,无损害 未见炎症细胞浸润 轻度
    1级(1分) 轻度局部破坏<5% 轻度损害 轻度,<10个炎症细胞/胰岛 中度
    2级(2分) 中度小叶破坏5%~20% 中度损害 中度,11~55个炎症细胞/胰岛 重度
    3级(3分) 严重小叶破坏21%~40% 严重损害,胰岛不存在 重度,>55个炎症细胞/胰岛 -
    4级(4分) 广泛弥漫性破坏>40% - - -
    下载: 导出CSV
  • [1] Immer FF. Organ donation after circulatory death in Switzerland:slow but constant progress[J]. Swiss Med Wkly, 2015, 145:w14062. https://www.ncbi.nlm.nih.gov/pubmed/25587710
    [2] Rana A, Gruessner A, Agopian VG, et al. Survival benefit of solid-organ transplant in the United States[J]. JAMA Surg, 2015, 150(3):252-259. doi: 10.1001/jamasurg.2014.2038
    [3] Brant SM, Cobert ML, West LM, et al. Characterizing cardiac donation after circulatory death:implications for perfusion preservation[J]. Ann Thorac Surg, 2014, 98(6):2107-2114. doi: 10.1016/j.athoracsur.2014.05.091
    [4] Salmeron-Rodriguez MD, Navarro-Cabello MD, Agüera-Morales ML, et al. Short-term evolution of renal transplant with grafts from donation after cardiac death:Type Ⅲ Maastricht category[J]. Transplant Proc, 2015, 47(1):23-26. doi: 10.1016/j.transproceed.2014.11.012
    [5] Kwon AH, Inui H, Yoshida K, et al. Pancreatic islet preservation at temperatures just above the freezing point[J]. Transplant Proc, 2003, 35(1):480-482. doi: 10.1016/S0041-1345(02)03843-5
    [6] Kuroda Y, Fujino Y, Kawamura T, et al. Mechanism of oxygenation of pancreas during preservation by a two-layer (Euro-Collins' solution/perfluorochemical) cold-storage method[J]. Transplantation, 1990, 49(4):694-696. doi: 10.1097/00007890-199004000-00008
    [7] Linn T, Schmitz J, Hauck-Schmalenberger I, et al. Ischaemia is linked to inflammation and induction of angiogenesis in pancreatic islets[J]. Clin Exp Immunol, 2006, 144(2):179-187. doi: 10.1111/cei.2006.144.issue-2
    [8] Ramachandran S, Desai NM, Goers TA, et al. Improved islet yields from pancreas preserved in perflurocarbon is via inhibition of apoptosis mediated by mitochondrial pathway[J]. Am J Transplant, 2006, 6(7):1696-1703. doi: 10.1111/ajt.2006.6.issue-7
    [9] Tanaka T, Suzuki Y, Tanioka Y, et al. Possibility of islet transplantation from a nonheartbeating donor pancreas resuscitated by the two-layer method[J]. Transplantation, 2005, 80(6):738-742. doi: 10.1097/01.TP.0000174136.70282.5A
    [10] Weegman BP, Suszynski TM, Scott WE 3rd, et al. Temperature profiles of different cooling methods in porcine pancreas procurement[J]. Xenotransplantation, 2014, 21(6):574-581. doi: 10.1111/xen.2014.21.issue-6
    [11] Huang J, Millis JM, Mao Y, et al. A pilot programme of organ donation after cardiac death in China[J]. Lancet, 2012, 379(9818):862-865. doi: 10.1016/S0140-6736(11)61086-6
    [12] Demos DS, Iyengar A, Bryner BS, et al. Successful porcine renal transplantation after 60 minutes of donor warm ischemia:extracorporeal perfusion and thrombolytics[J].ASAIO J, 2015[Epub ahead of print]. https://www.ncbi.nlm.nih.gov/pubmed/25851315
    [13] Seal JB, Bohorquez H, Reichman T, et al. Thrombolytic protocol minimizes ischemic-type biliary complications in liver transplantation from donation after circulatory death donors[J]. Liver Transpl, 2015, 21(3):321-328. doi: 10.1002/lt.v21.3
    [14] Emamaullee JA, Shapiro AM. Interventional strategies to prevent beta-cell apoptosis in islet transplantation[J]. Diabetes, 2006, 55(7):1907-1914. doi: 10.2337/db05-1254
    [15] Matsumoto S, Okitsu T, Iwanaga Y, et al. Successful islet transplantation from nonheartbeating donor pancreata using modified Ricordi islet isolation method[J]. Transplantation, 2006, 82(4):460-465. doi: 10.1097/01.tp.0000231710.37981.64
    [16] Pileggi A, Cobianchi L, Inverardi L, et al. Overcoming the challenges now limiting islet transplantation:a sequential, integrated approach[J]. Ann N Y Acad Sci, 2006, 1079:383-398. doi: 10.1196/annals.1375.059
    [17] Siskind E, Akerman M, Maloney C, et al. Pancreas transplantation from donors after cardiac death:an update of the UNOS database[J]. Pancreas, 2014, 43(4):544-547. doi: 10.1097/MPA.0000000000000084
  • 加载中
图(1) / 表(1)
计量
  • 文章访问数:  115
  • HTML全文浏览量:  69
  • PDF下载量:  13
  • 被引次数: 0
出版历程
  • 收稿日期:  2015-06-25
  • 网络出版日期:  2021-04-29
  • 刊出日期:  2015-09-01

目录

    /

    返回文章
    返回