Practical Journal of Organ Transplantation(Electronic Version) ›› 2020, Vol. 8 ›› Issue (4): 256-260.DOI: 10.3969/j.issn.2095-5332.2020.04.005

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The effect of in vivo local normothermic perfusion in vivo on the repair of liver in donation aftercardiac death porcine livers

Li Peng 1 ,Tan Xiaoyu 2 ,Lei Zhibin 1 ,Chen Yao 1 ,Wang Chunzheng 1 ,He Xiran 1 ,Kuang Weijian 1 ,Guo Jiaxian 1 , Chen Suping 1 ,Ouyang Qing 2 ,He Huan 2 ,Chen Jianxiong 2 ,Lin yanzhi 1 ,Huo Feng 2 .   

  1. 1. Guangdong Shunde Industrial Design Institute(Guangdong Shunde Innovation Design Institute),Foshan 528311,Guangdong,China;

    2. Hepatobiliary surgery of Southern Theater General Hospital,Guangzhou 510010,Guangdong,China

  • Online:2020-07-20 Published:2021-05-10

在体常温局部灌注对猪心死亡供体肝脏的修复作用

李鹏 1 ,谭晓宇2 ,雷志斌1 ,陈耀 1 ,王春政1 ,何锡然 1 ,邝伟键 1 ,郭家钘 1 ,陈素平 1,欧阳青 2 ,何洹2 ,陈建雄2 ,林炎志 1 ,霍枫2
  

  1. 1. 广东顺德工业设计研究院(广东顺德创 新设计研究院〕,广东 佛山 5283111 ; 2. 中国人民解放军南部战区总医院肝胆外科与 肝移植中心,广东 广州 510010
  • 基金资助:

    公民心死亡器官捐献移植体系建设及关键技术研究(2012A030400023);

    军队实验动物专项科研项目〔SYDW(2017)12〕;

    国家 青年科学基金项目(81800556);

    广东省基础与应用基础研究基金项目(2020A1515010557);

    佛山顺德区重大科技计划项目“离体肝脏机械灌注 系统研发项目”〔顺府办函(2019)42 号〕;

    广东省自然科学基金面上项目(2020A151501561);

    广州市基础与应用基础研究项目(202002030201)

Abstract:

Objective To explore the effect of local normothermic perfusion on the repair of donation after cardiac death porcine livers. Methods 45 kg Bama minipigs(n = 3)were used in V-A extracorporeal membrane oxygenation(ECMO)perfusion after anesthesia. The devices were drained from the jugular vein,perfused through the iliac artery,and the balloon blocked the thoracic aorta,the device was started after 30 min of cardiac arrest at the temperature of 37℃ . The venous blood oxygen saturation was maintained between 60% and 70% by adjusting the flow rate of circle blood in 4 h of machine perfution. Blood gas and biochemical parameters were detected every hour. Livertissue was obtained before and after perfusion for H&E staining. Results During the 4 h perfusion,the equipment operated stably. Lactic acid was decreased significantly(P < 0.05),and bile was produced all the time. The alanine aminotransferase,glutamyl transpeptidase and total bilirubin were not significantly different(P > 0.05),aspartate aminotransferase concentration in the normal range. The pathological scores were extremely significance different between before and after perfusion(P < 0.01). Conclusion This study proved that local normothermic perfusion can repair the DCD porcine livers with 30 cardiac arrest.

Key words: In situ machine perfusion device, Donation after cardiac Death, Liver repair

摘要:

目的 探讨在体常温局部灌注对猪心脏死亡器官捐献(donation after cardiac death,DCD) 肝脏的修复作用。方法 45 kg 巴马小型猪(n = 3)在麻醉后,分别经颈静脉、髂动脉插入导管并与体 外膜肺氧合(extracorporeal membrane oxygenation,ECMO)连接。静脉注射氯化钾溶液引发心跳骤停, 30 min 后置入球囊导管阻断胸主动脉,开始运转设备进行在体常温(37℃)局部灌注 4 h,静脉血氧维持在 60% ~ 70%,每隔 1 h 检测其血气、生化指标,灌注前、后取肝脏组织,进行病理观察。结果 4 h 灌注过程中, 设备运转稳定,乳酸显著下降(P < 0.05),肝脏持续有胆汁生成,丙氨酸转氨酶、谷氨酰转肽酶及总胆红 素浓度变化无统计学差异(P > 0.05),天冬氨酸转氨酶在正常范围内,病理切片提示灌注前、后的病理评 分差异极其显著(P < 0.01)。结论 本研究证明在体常温局部灌注对猪 DCD 30 min 肝脏具有修复作用。

关键词: 在体机械灌注设备 , 心死亡供体 , 肝脏修复