Ex-vivo perfusion as a successful strategy for reduction of ischemia-reperfusion injury in prolonged muscle flap preservation - A gene expression study
Ex-vivo perfusion as a successful strategy for reduction of ischemia-reperfusion injury in prolonged muscle flap preservation - A gene expression study
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DOI：
10.1016/j.gene.2019.03.021
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发表时间：
2019-06-15
期刊：
影响因子：
3.5
通讯作者：
Ulrich, Dietmar J. O.
中科院分区：
文献类型：
--
作者：
Kruit, Anne Sophie;Smits, Laura;Ulrich, Dietmar J. O.
简介：随着血管化复合同种异体移植（VCA）作为新的外科技术的引入，需要能够安全地延长移植物保存的策略。离体机械灌注是一种很有前途的技术，目前已应用于实体器官移植。VCA和游离皮瓣移植领域的证据仍然有限。本基因表达研究的目的是评估缺血再灌注（IR）损伤的程度后，保存和再植的自由肌瓣在猪model.Materials和方法：首先进行微阵列分析保存的离体灌注与冷藏的肌瓣，选择感兴趣的基因作进一步调查。然后使用qRT-PCR在18小时离体灌注后的肌瓣再植模型（n = 14）中检查这些选择的基因的表达。将两种保存溶液与静态冷藏进行比较：威斯康星大学-mp（n = 5）和组氨酸-色氨酸-酮戊二酸溶液（n = 5）。肿瘤坏死因子受体超家族成员10-A样，G蛋白信号传导调节因子2，核因子κ β抑制剂zeta，白细胞介素-1 β，成纤维细胞生长因子6和DNA损伤诱导转录物4，缺氧诱导因子1-α和半胱天冬酶-3。肌瓣再植实验比较了它们在保存和再植前后的表达模式，并且显示保存组之间的基因表达总体上相当。结论：离体灌注和静态冷藏组之间缺血、凋亡和炎症相关基因的表达相当。这些结果表明，离体灌注可能是一种有前途的技术，为18小时的肌肉保存在减少缺血-再灌注损伤。
Introduction: With the introduction of vascularized composite allotransplantation (VCA) as new surgical technique, the need arose for strategies that could safely prolong graft preservation. Ex-vivo machine perfusion is a promising technique and is currently applied in solid organ transplantation. There is still limited evidence in the field of VCA and free flap transplantation. This gene expression study aimed to assess the degree of ischemia-reperfusion (IR) injury after preservation and replantation of free muscle flaps in a porcine model.Materials and methods: A microarray analysis was first conducted on muscle flaps preserved by ex-vivo perfusion versus cold storage, to select genes of interest for further investigation. The expression of these selected genes was then examined in a muscle flap replantation model after 18 hour ex-vivo perfusion (n = 14) using qRT-PCR. Two preservation solutions were compared to static cold storage: University of Wisconsin-mp (n = 5) and Histidine-Tryptophan-Ketoglutarate solution (n = 5).Results: A selection of 8 genes was made based on micro-array results: Tumor necrosis factor receptor superfamily member 10-A like, Regulator of G-protein signaling 2, Nuclear factor kappa beta inhibitor zeta, Interleukin-1 beta, Fibroblast growth factor 6 and DNA damage-inducible transcript 4, Hypoxia-inducible factor 1-alpha and Caspase-3. The muscle flap replantation experiment compared their expression patterns before and after preservation and replantation and showed overall comparable gene expression between the preservation groups.Conclusions: The expression of genes related to ischemia, apoptosis and inflammation was comparable between the ex-vivo perfusion and static cold storage groups. These results suggest that ex-vivo perfusion might be a promising technique for 18 hour muscle preservation in terms of decreasing ischemia-reperfusion injury.