Discriminant quantitation of posttransplant hepatic reticuloendothelial function. The impact of ischemic preservation.
Discriminant quantitation of posttransplant hepatic reticuloendothelial function. The impact of ischemic preservation.
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移植后肝网状内皮功能的判别定量。
DOI：
10.1097/00007890-199604270-00006
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发表时间：
1996
期刊：
影响因子：
6.2
通讯作者：
Bulkley,GB
中科院分区：
文献类型：
--
作者：
Klein,AS;Zhadkevich,M;Wang,D;Margolick,JB;Winkelstein,JA;Bulkley,GB
本研究重点关注不同缺血保存条件下移植后肝网状内皮系统（RES）功能的两个独立组成部分——吞噬作用和杀灭细菌。我们之前报道过，给大鼠静脉注射 51 Cr 和 125 I 双标记大肠杆菌后，肝脏 51 Cr 水平可用于可靠地量化肝脏吞噬细胞从血液中清除细菌 (HPC)，而随后从肝脏中释放 125 I 则准确地与肝脏细菌杀灭平行。在这里，Wistar 大鼠被移植了同种肝脏，灌注了生理盐水 (NS) 或威斯康星大学溶液 (UW)，并在植入前在 4°C 下保存 1、2 或 3 小时。对照大鼠接受剖腹手术和肝动脉结扎。使用双标记大肠杆菌检测，与对照组相比，所有移植动物的 HPC 均下降，并在术后第三天达到最低点（P < 0.05）。在移植了保存在 NS 中的肝脏的大鼠中，冷缺血 1、2 或 3 小时后，随后被杀死的吞噬生物体的分数（肝脏杀死效率 = HKE）分别增加至正常值的 142%、129% 或 112%； P<0.05）。相反，UW 中供体同种异体移植物的保存与 HKE 的显着抑制相关。此外，与肝动脉结扎对照组（死亡率为 12%）相比，接受 NS 或 UW 保存肝脏的大鼠在 7 天时对肺炎链球菌静脉注射的耐受性较差（死亡率为 50%）。 NS 中大鼠肝脏的缺血保存导致肝脏吞噬作用的剂量（缺血）依赖性减少以及 HKE 的增强。然而，在威斯康辛大学的保存对肝 RES 功能的两个组成部分产生了显着的抑制。脓毒症攻击后，两组移植大鼠的存活率均下降。
This study focuses upon two discrete components of posttransplant hepatic reticuloendothelial system (RES) function-phagocytosis and killing of bacteria-under various conditions of ischemic preservation. We had previously reported that, following intravenous injection of rats with 51 Cr and 125 I double-labeled Escherichia coli, hepatic 51 Cr levels can be used to reliably quantify hepatic phagocytic clearance of the bacteria from the blood (HPC), while the subsequent release of 125 I from the liver accurately parallels hepatic bacterial killing. Here, Wistar rats were transplanted with syngeneic livers perfused with either normal saline (NS) or University of Wisconsin solution (UW) and stored at 4 C for 1, 2, or 3 hr prior to implantation. Control rats underwent laparotomy and hepatic artery ligation. Using the double-labeled E coli assay, HPC was decreased in all transplanted animals when compared with controls, reaching a nadir on the third postoperative day (P< 0.05). In rats transplanted with livers preserved in NS, the fraction of phagocytosed organisms that were subsequently killed (hepatic killing efficiency= HKE) was increased to 142%, 129%, or 112% of normal following 1, 2, or 3 hr of cold ischemia, respectively; P< 0.05). Conversely, preservation of donor allografts in UW was associated with marked depression of HKE. Moreover, rats receiving NS-or UW-preserved livers tolerated an intravenous challenge with Streptococcus pneumoniae poorly (50% mortality) compared with hepatic artery ligated controls (12% mortality) at 7 days. Ischemic preservation of rat livers in NS resulted in a dose (of ischemia)-dependent reduction of hepatic phagocytosis coupled with a potentiation of HKE. Preservation in UW, however, produced a striking suppression of both components of hepatic RES function. Following a septic challenge survival was reduced in both groups of transplanted rats.