The effects of fasting on the quality of liver preservation by simple cold storage.
The effects of fasting on the quality of liver preservation by simple cold storage.
复制标题
禁食对单纯冷藏肝脏保存质量的影响。
DOI：
10.1097/00007890-199012000-00008
复制
发表时间：
1990
期刊：
影响因子：
6.2
通讯作者：
Belzer,FO
中科院分区：
文献类型：
--
作者：
Boudjema,K;Lindell,SL;Southard,JH;Belzer,FO
虽然肝脏可以成功保存24小时或更长时间，但通常移植的肝脏功能较差或没有（原发性无功能）。肝脏的质量似乎不取决于保存的时间，而可能取决于供体的状况。在这项研究中，我们研究了禁食对肝脏移植质量的影响。兔禁食（48小时），肝脏在UW溶液中保存6-8小时。通过离体灌注2小时分析肝脏功能。此外，猪禁食72小时，肝脏保存12小时，并通过原位移植测定活力。禁食消耗了85%的肝糖原，但对ATP和谷胱甘肽浓度没有影响。禁食动物的兔肝脏产生相似数量的胆汁，向灌注液中释放相似浓度的乳酸脱氢酶（LDH）和天冬氨酸转氨酶（AST），组织中保持相似浓度的ATP和谷胱甘肽，保存24小时后细胞内K: Na比与喂养动物的肝脏相似。保存48小时后，禁食动物肝脏的活力低于喂食动物肝脏，包括：胆汁产量减少（2.0+/-0.3比5.0+/-0.9 ml/2小时，100 g）， LDH释放量增加（3701+/-562单位比1123+/-98单位）和AST释放量增加，ATP减少（0.326+/-74比0.802+/-160 nmol/g），谷胱甘肽减少（0.303+/-13比0.933+/-137 nmol/g）， K: Na比降低（1.5+/-0.9比7.4+/-0.6）。接受保存12小时的饲料动物肝脏的猪的存活率（5/ 6,83%）高于禁食动物肝脏的存活率（3/ 6,50%）。结果表明，供体的营养状况会影响肝脏保存和移植的结果。禁食动物肝脏损伤的增加可能是由于糖原的损失，糖原可能是移植后最初阶段的重要能量来源。在临床肝移植中，供体的营养状况可能是影响肝脏初始功能的重要因素，提高供体营养状况的方法可能是提高肝脏质量的重要方法。
Although livers can be successfully preserved for 24 hr or more, often the transplanted livers have poor or no (primary nonfunction) function. The quality of the liver does not appear dependent upon the time of preservation but may be dependent upon the condition of the donor. In this study we have investigated the effects of fasting on the quality of livers for transplantation. Rabbits were fasted (48 hr) and livers preserved in the UW solution for 6-8 hr. Functions of the liver were analyzed by isolated perfusion for 2 hr. Also, pigs were fasted for 72 hr, livers preserved for 12 hr, and viability determined by orthotopic transplantation. Fasting depleted the liver glycogen by 85% but had no effect on ATP or glutathione concentrations. Rabbit livers from fasted animals produced similar amounts of bile, released similar concentrations of lactate dehydrogenase (LDH) and aspartate amino transaminase (AST) into the perfusate, maintained similar concentrations of ATP and glutathione in the tissue, and had a similar intracellular K: Na ratio after 24-hr preservation when compared to livers from fed animals. After 48-hr preservation, livers from fasted animals were less viable than livers from fed animals, including: reduced bile production (2.0+/-0.3 vs. 5.0+/-0.9 ml/2 hr, 100 g), greater release of LDH (3701+/-562 units vs. 1123+/-98 units) and AST, less ATP (0.326+/-74 vs. 0.802+/-160 nmol/g), less glutathione (0.303+/-13 vs. 0.933+/-137 nmol/g), and a lower K: Na ratio (1.5+/-0.9 vs. 7.4+/-0.6). Pigs receiving livers from fed animals preserved for 12 hr had better survival (5/6, 83%) than livers from fasted animals (3/6, 50%). The results show that the nutritional status of the donor can affect the outcome of liver preservation and transplantation. Increased injury in livers from fasted animals may be due to the loss of glycogen that may be an essential source of energy in the initial posttransplant period. In clinical liver transplantation the nutritional status of the donor may be an important factor in the initial function of the liver, and methods to increase the nutritional status of the donor may be important in increasing the quality of livers.