Livers from fasted rats acquire resistance to warm and cold ischemia injury.
Livers from fasted rats acquire resistance to warm and cold ischemia injury.
复制标题
禁食大鼠的肝脏获得了对热和冷缺血损伤的抵抗力。
DOI：
10.1097/00007890-199304000-00008
复制
发表时间：
1993
期刊：
影响因子：
6.2
通讯作者：
F. Belzer
中科院分区：
文献类型：
--
作者：
R. Sumimoto;J. Southard;F. Belzer
成功的肝移植取决于许多因素，其中之一是供体器官的质量。先前的研究表明，供体的营养状况可能会影响肝移植的结果，而由于长时间留在重症监护室，饥饿可能会对肝脏产生不利影响。在这项研究中，我们使用原位大鼠肝移植模型来衡量禁食供体如何影响肝移植的结果。用UW溶液在37 ℃（热缺血45-60分钟）或4 ℃（冷缺血30或44小时）保存大鼠肝脏。保存后的肝脏原位移植和生存（7天）进行了测量，以及移植后6小时肝功能。热缺血45分钟后，50%（3/6）的动物存活时，肝脏是从一个喂养的供体约80%（45）的肝脏是从一个禁食三天的供体。热缺血60分钟后，无动物存活（0/8，进食组）。然而，如果供体禁食3天，89%（89）的动物存活7天。冷藏30小时的肝脏存活率为50%（6个中的3个），禁食1-3天不会影响这一结果。然而，如果供体禁食4天，则获得100%（9/9）的存活率。保存44小时后，只有29%（2/7）的受体存活7天。如果供体禁食4天，存活率增加到83%（5/6）。禁食大鼠的肝功能、胆汁生成和血清酶均优于进食大鼠。禁食导致肝糖原含量下降95%。即使在这种低浓度的糖原下，热或冷缺血后的肝脏活力（动物存活率）也不受影响，糖原含量低的肝脏完全存活。因此，肝糖原在肝脏保存中似乎并不重要。这项研究表明，供者禁食不会导致热或冷缺血后的肝脏损伤。事实上，从禁食大鼠获得的肝脏似乎能够更好地耐受缺血。因此，供者的营养状况可能是影响肝移植效果的一个重要因素。来自禁食供体的肝脏可能比来自进食供体的肝脏能够更好地耐受长期保存。
Successful liver transplantation is dependent upon many factors, one of which is the quality of the donor organ. Previous studies have suggested that the donor nutritional status may affect the outcome of liver transplantation and starvation, due to prolonged stay in the intensive care unit, may adversely affect the liver. In this study we have used the orthotopic rat liver transplant model to measure how fasting the donor affects the outcome of liver transplantation. Rat livers were preserved with UW solution either at 37 degrees C (warm ischemia for 45-60 min) or at 4 degrees C (cold ischemia for 30 or 44 hr). After preservation the livers were orthotopically transplanted and survival (for 7 days) was measured, as well as liver functions 6 hr after transplantation. After 45 min of warm ischemia 50% (3 of 6) animals survived when the liver was obtained from a fed donor about 80% (4 of 5) survived when the liver was obtained from a three-day-fasted donor. After 60 min warm ischemia no animal survived (0 of 8, fed group). However, if the donor was fasted for 3 days 89% (8 of 9) of the animals survived for 7 days. Livers cold-stored for 30 hr were 50% viable (3 of 6) and fasting for 1-3 days did not affect this outcome. However, if the donor was fasted for 4 days 100% (9 of 9) survival was obtained. After 44-hr preservation only 29% (2/7) of the recipients survived for 7 days. If the donor was fasted for 4 days, survival increased to 83% (5/6). Liver functions, bile production, and serum enzymes were better in livers from the fasted rats than from the fed rats. Fasting caused a 95% decrease in liver glycogen content. Even with this low concentration of glycogen, liver viability (animal survival) after warm or cold ischemia was not affected, and livers with a low glycogen content were fully viable. Thus liver glycogen does not appear to be important in liver preservation. This study shows that fasting the donor does not cause injury to the liver after warm or cold ischemia. In fact, the livers appeared to be better able to tolerate ischemia when obtained from fasted rats. Thus donor nutritional status may be an important factor for outcome of liver transplantation. Livers from fasted donors may be capable of tolerating long-term preservation better than livers from fed donors.