新型常溫機械灌注裝置保存豬DCD供腎的實驗研究
發(fā)布時間:2018-04-13 14:23
本文選題:常溫機械灌注 + 腎移植 ; 參考:《實用器官移植電子雜志》2017年03期
【摘要】:目的構建新型常溫機械灌注(normothermic machine perfusion,NMP)系統(tǒng),利用豬自體腎移植模型,探討NMP改善豬心臟死亡器官捐獻(donation after cardiac death,DCD)供腎保存質量及相關機制。方法選用健康巴馬小型豬10只,隨機分為兩組,在原位夾閉右腎動脈30分鐘后,UW液低溫灌注,A組(n=5)以NMP保存8小時,B組(n=5)以UW液4℃低溫保存8小時,然后兩組均行自體腎移植術,比較術后血清生化指標、腎組織病理變化、細胞因子的表達情況等指標。結果兩組均成功在經過30分鐘熱缺血和8小時保存后,進行自體腎移植。血流開放1小時后,A組腎組織免疫組化腫瘤壞死因子-α(tumor necrosis factor-α,TNF-α)、天冬氨酸特異性半胱氨酸蛋白酶-3(cysteinyl aspartate specific proteinase-3,Caspase-3)、內毒素(endotoxin-1,ET-1)水平明顯低于B組,TUNEL法測定凋亡細胞比例也明顯低于B組,兩組之間差異有統(tǒng)計學意義(P0.05);血流開放6小時后,A組血清肌酐(serum creatinine,SCr)、TNF-α、Caspase-3水平明顯低于B組,兩組之間差異有統(tǒng)計學意義(P0.05);開放后腎臟活檢常規(guī)病理檢查提示,A組腎臟損傷程度明顯減輕。結論 NMP保存可明顯減輕豬DCD供腎的缺血/再灌注損傷;其保護機制與NMP可模擬器官的生理環(huán)境,維持充足能量與氧氣供應,減少保存期間和再灌注后炎性細胞因子釋放等有關。
[Abstract]:Objective to establish a new normothermic machine perfusion (NMP) system, and to explore the mechanism of NMP in improving the quality of donor kidney by using porcine autogenous kidney transplantation model.Methods Ten healthy Bama miniature pigs were randomly divided into two groups. The right renal artery was clamped in situ for 30 minutes. The rats in group A were perfused with UW solution for 30 minutes. The rats in group B were treated with NMP for 8 hours. The rats in group B were preserved with UW solution at 4 鈩,
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