新型常温机械灌注装置保存猪DCD供肾的实验研究

发布时间：2018-04-13 14:23

  本文选题：常温机械灌注 + 肾移植　； 参考：《实用器官移植电子杂志》2017年03期

【摘要】：目的构建新型常温机械灌注(normothermic machine perfusion,NMP)系统,利用猪自体肾移植模型,探讨NMP改善猪心脏死亡器官捐献(donation after cardiac death,DCD)供肾保存质量及相关机制。方法选用健康巴马小型猪10只,随机分为两组,在原位夹闭右肾动脉30分钟后,UW液低温灌注,A组(n=5)以NMP保存8小时,B组(n=5)以UW液4℃低温保存8小时,然后两组均行自体肾移植术,比较术后血清生化指标、肾组织病理变化、细胞因子的表达情况等指标。结果两组均成功在经过30分钟热缺血和8小时保存后,进行自体肾移植。血流开放1小时后,A组肾组织免疫组化肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、天冬氨酸特异性半胱氨酸蛋白酶-3(cysteinyl aspartate specific proteinase-3,Caspase-3)、内毒素(endotoxin-1,ET-1)水平明显低于B组,TUNEL法测定凋亡细胞比例也明显低于B组,两组之间差异有统计学意义(P0.05);血流开放6小时后,A组血清肌酐(serum creatinine,SCr)、TNF-α、Caspase-3水平明显低于B组,两组之间差异有统计学意义(P0.05);开放后肾脏活检常规病理检查提示,A组肾脏损伤程度明显减轻。结论 NMP保存可明显减轻猪DCD供肾的缺血/再灌注损伤;其保护机制与NMP可模拟器官的生理环境,维持充足能量与氧气供应,减少保存期间和再灌注后炎性细胞因子释放等有关。
[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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