亚常温机械灌注保存人边缘性供肝的实验研究

发布时间：2018-03-16 16:16

本文选题：肝移植　切入点：器官保存　出处：《浙江大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本研究探索亚常温机械氧合灌注保存人边缘性供肝的可行性及有效性。方法:2016年6月至2017年2月,共计9例人废弃供肝纳入实验,采用体外常温机械氧合灌注(SNMP)方法保存。收集机械灌注装置的组装及调节时间和灌注保存过程中灌注液的血气分析及生化结果,并留取灌注前后肝脏组织做病理组织检查,分析比较灌注前后供肝功能变化情况。结果:灌注系统组装及调整较方便,9例实验均未出现灌注失败事件,灌注后灌注液的pH为7.14±0.09,胆汁分泌8.2±2.8mL/min,肝动脉血管阻力指数324.7±107.2 mmHg/(L/min),门静脉血管阻力指数 6.9±1.7 mmHg/(L/min),渗透压 344.3±7.6 mOsm/kg,血糖 19.2±3.4mmol/L,乳酸 15.2±1.6 mmol/L,谷丙转氨酶 2951.1± 1383.2 U/L,谷草转氨酶4788.1±1085.9 U/L,腺苷脱氨酶44.2±.0 U/L,胆碱酯酶224.9±22.7 U/L,γ-谷氨酰胺转肽酶22.9±6.4 U/L,病理切片观察可见灌注前后肝脏病理无明显变化,未见细胞损伤进展。结论:亚常温机械灌注可有效维持人肝的生理功能,延缓肝脏损伤,维持肝脏活力,有望通过系列干预措施逆转边缘性供肝,进而扩大供肝来源。
[Abstract]:Objective: to explore the feasibility and effectiveness of mechanical oxygenation at subnormal temperature for the preservation of marginal donor liver in human beings. Methods: from June 2016 to February 2017, 9 cases of abandoned donor liver were included in the experiment. The method of mechanical oxygenation perfusion (SNMPP) in vitro was used to collect the assembly and adjustment time of mechanical perfusion device, the blood gas analysis and biochemical results of perfusion fluid during perfusion and preservation, and the pathological examination of liver tissue before and after perfusion. The changes of donor liver function before and after perfusion were analyzed and compared. Results: no perfusion failure occurred in 9 cases of perfusion system assembly and adjustment. After perfusion, pH was 7.14 卤0.09, bile secreted 8.2 卤2.8 mmol / min, hepatic artery vascular resistance index 324.7 卤107.2 mm HgP / min, portal vein resistance index 6.9 卤1.7 mmHgP / min, osmotic pressure 344.3 卤7.6 mm Osm-P 路kg, blood glucose 19.2 卤3.4 mmol / L, lactate 15.2 卤1.6 mmol / L, alanine transaminase 2951.1 卤1383.2 UP / L, glutamic oxaloacetic transaminase 4788.1 卤1085.9 UP / L, glandular gland. 44.2 卤.0 U / L of glucodeaminase, 224.9 卤22.7 U / L of cholinesterase and 22.9 卤6.4 U / L of 纬 -glutamine transpeptidase, respectively. Conclusion: mechanical perfusion at subnormal temperature can effectively maintain the physiological function of human liver, delay liver injury and maintain liver vitality, which is expected to reverse the marginal donor liver through a series of intervention measures, and then expand the source of donor liver.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R657.3

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