Comparative study of effect of mechanical perfusion and simple cold preservation on DCD pancreas in pigs
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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。 Abstract:Objective To compare the effect of mechanical perfusion and simple cold preservation on donation after cardiac death (DCD) pancreas in pigs. Methods Ten healthy pigs were randomized into simple cold preservation group and the mechanical perfusion group (5 pigs in each group). DCD model was established in pigs. The pancreas was cut and stored in University of Wisconsin solution (UW solution). The pancreas of the simple cold preservation group was preserved with simple UW solution and that of the mechanical perfusion group was preserved by mechanical perfusion. Specimen was collected from pancreatic tail at 1, 2, 3, 4, 6 and 24 h to prepare tissue section. Then, the tissue section was stained with hematoxylin-eosin (HE). Histopathological examination was conducted and pathological score of the two groups was compared. Results Microthrombus in DCD pancreas of pig was removed at 180 min of mechanical perfusion and injury to pancreas islet caused by excessive perfusion was avoided. The pathological score of the mechanical perfusion group was (4.2±0.8) and that of the simple cold preservation group was (8.4±1.1), and the difference had statistical significance (P < 0.05). Conclusions Mechanical perfusion may effectively remove thrombus in pancreatic vessels. Compared with simple cold preservation, mechanical perfusion may maintain the integrity of pancreas islet better after the preservation of the same period of time. -
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% - - - -
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