Assessment of graft viability after cold preservation in small intestinal transplantation.

移植物活性的准确评估被认为是重要的，然而仍然有一些方法仍然存在争议。我们从生理特性、能量代谢、组织血流和组织学方面探讨了评估移植物存活能力的方法。同种异位移植是用Lewis大鼠进行的，移植的空肠用UW液冷保存6、12、24或48小时。分别于移植前、切取时、冷藏结束时、再灌注前和再灌注30min取材，进行组织学观察和腺嘌呤核苷酸测定(高效液相色谱法)。再灌流时用激光多普勒血流仪记录移植物的组织血流量，保存0、24、48h时，同时显示双相神经活动(兴奋和抑制)和自发节律活动的标本的阳性率分别为100%、88%和25%。再灌流后，24小时内恢复至收获时的30%以上，48小时组仍低于30%。48h组再灌流5min或30min的血流量明显低于其他组。再灌注后组织学损害，48小时组深达隐窝层，其他组局限于绒毛内，与生理学、能量代谢和组织血流结果有良好的相关性。移植前的生理特性以及再灌注后组织的ATP水平和血流量被认为是评估移植物存活的有用指标。这些结果与我们之前报道的受体存活率相关。

The precise assessment of graft viability is thought to be important, however there are still a few methods which remain controversial. We investigated the method for the assessment of small bowel graft viability, by means of physiological properties, energy metabolism, tissue blood flow, and the histological findings.Syngeneic heterotopic transplantation was performed using Lewisrats, after a cold preservation of a jejunal graft with UW solution for 6, 12, 24, or 48hr. Graft samples were taken before transplantation for physiological study, and at harvesting, at the end of cold storage, before and 30 min after reperfusion for histology and for the measurement of adenine nucleotides (HPLC method). The tissue blood flow of the graft was recorded using a laserdoppler flowmeter at reperfusion.The positive rates of samples showing both the biphasic nervous activities (excitation and inhibition) and the spontaneous rhythmic activity was 100%, 88%, and 25% in 0, 24, and 48 hr preservation, respectively. The level of ATP after reperfusion, which recovered to more than 30% of that at harvesting within 24 hr preservation groups but remained at less than 30% in the 48 hr group. The blood flow level at 5 or 30 min of reperfusion was significantly lower in the 48 hr group than that in the other groups. Histological damage after reperfusion, which extended deep into the crypt layr in the 48 hr group, but was confinded within villi in the other groups, correlated well with the results of physiology, energy metabolism, and tissu blood folw.The physiological property before transplantation, and the tissue ATP level and blood flow after reperfusion are considered to be useful parameters for assessment of small bowel graft viability. These results are correlated with the recipient survival which we had previously reported.