长征-1号多器官保存液效果的动物实验研究

目的　研究长征１ 号（ＣＺ１） 多器官保存液对肾脏低温保存的有效性及移植存活率的影响。　方法　（１） 采用离体肾脏灌注模型,分别检测了低温延时保存后兔肾线粒体呼吸控制率（ＲＣＲ）、Ｎａ＋Ｋ＋ＡＴＰａｓｅ 活性、皮质线粒体Ｃａ２ ＋ 、皮质ＡＴＰ等含量的变化。（２） 采用ＳＤ 大鼠肾脏移植模型,分别观察了低温延时保存４８ 、７２ 小时后再移植,大鼠存活以及移植肾功能恢复情况。　结果　（１）ＣＺ１ 液组保存７２ 小时,其生化指标肾脏线粒体呼吸控制率、皮质线粒体Ｃａ２＋ 、皮质ＡＴＰ含量的变化均优于ＵＷ 液组;（２）经ＵＷ 液和ＣＺ１ 液低温保存供肾４８ 小时,７ 天之内肾功能恢复正常。保存供肾７２ 小时,１４ 天之内肾功能基本接近正常。　结论　长征１ 号多器官保存液对肾脏低温保存效果基本类同于ＵＷ 液,且部分生化学结果优于ＵＷ 液。     

自制多器官保存液对大鼠肝脏保存的效果

目的 探讨自制多器官保存液(self-designed multi-organ preservation solution,SMO)对大鼠肝脏低温保存的效果.方法 使用SMO液、UW液和肾脏保存液保存大鼠肝脏6、12和24 h后进行肝移植,观察移植后12 h肝功能改变和移植后14 d大鼠存活情况.结果 SMO液保存24 h之内,肝脏的形态学观测无明显改变.SMO液组与UW液组TB、ALT和血清透明质酸同步升高;肾脏保存液组显著升高,与SMO液组比较差异有统计学意义(F=49.027,70.280,34.349,71.532,446.544,303.408,P＜0.05).SMO液组肝移植后14 d大鼠存活情况良好.结论 大鼠原位肝移植模型证实,SMO液与UW液在保护肝脏功能方面作用相当,优于肾脏保存液.     

多器官保存液组成探讨

本文综述了器官保存的原理及要求，指出一种成功的器官保存液的组成应满足五个要求：１、减少由于低温保存导致的细胞水肿；２、防止细胞的酸化作用；３、防止灌洗保存过程中的细胞间隙膨胀；４、防止氧自由基损伤；５、提供再生高能磷酸化合物的底物。并对ＵＷ、ＨＴＫ液的各个组成部分进行了分析和探讨。     

自制多器官保存液对草犬肾脏低温保存的实验研究

目的 研究自制上海多器官(SMO)液对草犬肾脏低温保存的效果。方法 采用草犬肾脏非循环离体灌注模型，比较SMO液、Uw液和高渗枸椽酸盐嘌呤溶液(HC-A)对草犬肾脏保存后，其形态学及生物化学的改变，并进行肾脏移植，观察移植后肾功能恢复情况。结果 SMO液保存72h之内，肾脏的形态学无明显改变，其各项生化功能SMO组明显优于HC-A组(P＜0．05)；与Uw液组比较，肾脏线粒体呼吸控制率(RCR)、皮质ATP含量两组间差异有显著性(P＜0．05)；保存48、72h后保存液PH值，SMO组明显高于Uw组(P＜0.05)。结论 SMO液保存犬肾72h效果明显优于HC-A液，与UW液相当。     

长征-1号多器官保存液低温保存大鼠肺脏并移植的实验研究

目的 通过大鼠原位肺移模型,研究长征－１号多器官保存液保存肺的效果。方法 将大鼠随机分为３组;对组照;以平衡液灌洗供肺,并立即移植;ＣＺ－１液组;以ＣＺ－１液灌洗供肺,保存８小时后移植;Ｅｕｒｏ－Ｃｏｌｌｉｎｓ液组,以Ｅｕｒｏ－Ｃｏｌｌｉｎｓ液灌洗供肺,保存８小时后移植。     

多器官保存液组成探讨

本文综述了器官保存的原理及要求，指出一种成功的器官保存液的组成应满足五个要求：１、减少由于低温保存导致的细胞水肿；２、防止细胞的酸化作用；３、防止灌洗保存过程中的细胞间隙膨胀；４、防止氧自由基损伤；５、提供再生高能磷酸化合物的底物。并对ＵＷ、ＨＴＫ液的各个组成部分进行了分析和探讨。     

器官保存及保存液的研究

正器官移植是治疗各种器官终末期疾病的唯一有效治疗方案。随着器官移植医学的快速发展,尤其是手术技术的进步及新型免疫抑制剂、器官保存方式的应用,器官移植病人的生存率得到显著提高。器官移植也在世界范围内广泛开展。移植等待病人数量不断增加,远远超过器官捐献的数量,器官供应严重不足,而高质量的供体是器官移植成功的先决条件和基本保障[1]。     

不同保存液保存小肠的效果评估

目的 评价乳酸林格（ＬＲ）液、Ｅｕｒｏ－Ｃｏｌｌｉｎｓ（ＥＣ）液、高渗枸橼酸嘌呤（ＨＣ－Ａ）液和武汉医学院器官１号（ＭＷＯ－１）液保存猪小肠的效果。方法 根据不同保存液将动物随机分成４组,每组又根据保存时间不同分成３个亚组,供肠保存２后行自体移植。结果 小肠保存１０小时后移植,术后３周各组受体的存活率均为１００％;保存１８小时,ＬＲ液组、ＥＣ液组、ＨＣ＝Ａ液组和ＷＭＯ－１液组受体的存活率分别为６０     

携氧型保存液对兔肾的低温保存效果

目的 观察携氧型保存液对兔肾脏低温保存的效果.方法 将60只日本纯种大耳兔随机分为A(H-CA液,保存48h)、B(携氧保存液,保存48 h)、C(UW液,保存48 h)、D(H-CA液,保存72 h),E(携氧保存液,保存72 h)、F(UW液,保存72 h)6组.切取左肾,灌洗并放入该组保存液保存.肾动脉、静脉分别与右侧髂外动脉、髂外静脉端端套管吻合,输尿管腹壁造瘘,同时切除右侧肾脏,检测移植前后肾功能指标.结果 手术成功率95%,携氧型保存液各组术后血肌酐的峰值均低于H-CA液组,且血肌酐恢复正常的时间也较H-CA液组早(P<0.05);以上各指标与UW液组比较差异无统计学意义(P>0.05).结论 含全氟三丁胺携氧型保存液对供肾的保存效果明显好于H-CA保存液,可安全保存兔肾72 h.     

SMO保存液对犬肾低温保存期间线粒体功能的保护作用

目 的研究SMO保存液对犬肾低温保存期间线粒体功能的保护作用。方法 建立犬离体肾脏单纯低温保存模型，分别采用0～4℃的SMO保存液、HTK保存液和UW保存液对犬肾进行灌注和保存，并根据所用保存液的不同分为SMO组、HTK组和UW组。分别于低温保存2、24、48和72h后取各组的肾组织皮质标本，进行病理学观察并应用氧电极（Clark）法测定肾组织细胞线粒体的呼吸控制率（RCR）和磷／氧比（P／O）。结果 犬肾在保存48h和72h后，SMO组肾组织病理学改变较HTK组轻；保存24h内肾组织RCR与HTK组无明显差异，但其余时间点均高于HTK组（P〈0．05），保存72h时差异最为明显（P〈0．01）。SMO组犬肾保存2h后，肾组织的P／O比值与HTK组无明显差异（P〉0．05），但在保存24h后则明显高于HTK组（P〈0．05）。SMO组与UW组各项观察指标比较，差异无统计学意义（P〉0.05）。结论 SMO保存液在减轻细胞形态学改变和保持线粒体整体功能方面显著优于HTK保存液，与UW保存液效果相当。     

Improved renal preservation with PB-3 flush solution during 72 h of cold storage

Abstract Previously, PB-2 flush solution has been found to be superior to Collins 2 solution (C-2) in extending renal viability in the dog. To further characterize preservation mechanisms, we studied mitochondrial oxidative function during 72 h of cold storage comparing PB-3, UW-1, and C-2 flush storage solutions. Complex 1 dependent mitochondrial oxidative phosphorylation (MOP) was found to be significantly less ( P < 0.001) at 5 h and 72 h of cold storage ( P < 0.001) for the C-2 compared to the other flush groups. Complex 2 dependent MOP had parallel results, having significantly less function ( P < 0.002) at 5 h and 72 h ( P < 0.02) of cold storage in the C-2 group compared to the other groups. PB-3 and UW-1 solutions were noted to be comparable, suggesting possible equivalent preservation efficacy. Nevertheless the components of PB-3 at the level of MOP contributed significantly to better preservation compared to C-2 solution.     

新型器官保存液低温保存猪肾效果的研究

目的研究新型器官保存液Lifor液对猪肾脏的低温保存效果。方法 24只白色杂种猪,随机均分为Lifor液保存组和威斯康星大学保存液（UW液）组各12只,建立离体肾脏非循环灌注模型,供肾取出后分别以0~4℃的Lifor液和UW液灌注并低温保存,再根据保存时间随机分成2个亚组,分别为保存24h、48h组,然后行猪自体肾移植。比较两组肾脏低温保存结束后其病理学及肾皮质三磷腺苷（ATP）含量的改变,并观察自体肾移植后肾功能恢复情况。结果供肾离体保存24h、48h后,Lifor液组与UW液组的肾组织病理学改变基本一致,肾皮质ATP含量比较差异无统计学意义（P〉0.05）。移植后两组血清肌酐水平比较差异亦无统计学意义（P〉0.05）。结论 Lifor液低温保存肾脏的效果与UW液相当,且成本低廉,因此更具有临床应用前景。     

含饱和氢气肾保存液对大鼠肾脏冷缺血再灌注损伤的影响

目的 评价含饱和氢气肾保存液对大鼠肾脏冷缺血再灌注损伤的影响.方法 健康雄性Wistar大鼠24只,周龄8～10周,体重200～ 250 g,采用随机数字表法,将其随机分为3组(n=8):对照组(H1组)大鼠仅切除右肾;普通肾保存液组(H2组)大鼠采用冷缺血再灌注模型,用4℃普通HC-A肾保存液对左肾行冷灌注和冷保存;含饱和氢气肾保存液组(H3组)大鼠操作同H2组,灌注液及保存液换用自制的4℃含饱和氢气HC-A肾保存液.于再灌注24 h时抽取下腔静脉血样,测定血清BUN、Cr、TNF-α和IL-6浓度;切取左肾,测定肾组织MDA和8-羟基脱氧鸟苷(8-OHdG)含量,光镜下观察肾组织病理学结果.结果 与H1组相比,H2组和H3组大鼠血清BUN、Cr、TNF-α和IL-6浓度及肾组织MDA和8-OHdG含量均升高(P＜ 0.05);与H2组相比,H3组血清BUN、Cr、TNF-α和IL-6浓度及肾组织MDA和8-OHdG的含量均降低(P＜0.05).H1组肾组织形态结构未见明显异常,H2组肾小管损伤明显,H3组肾小管损伤较H2组减轻.结论 含饱和氢气肾保存液可明显减轻大鼠肾脏冷缺血再灌注损伤.     

胰、十二指肠及肾联合获取、修整和保存的实验研究

目的：对供者胰、十二指肠及肾等器官的联合获取、修整和保存方法进行研究。方法：采用原位腹主动脉插管、低温灌注、快速整块切取及体外修整获得可供移植的胰、十二指肠及肾移植物。2例用UW液保存的供胰用于实验研究。结果：获取8例供者的移植物,平均热缺血时间为4min50s,获取时间为18min20s。7例修整成适用于临床作胰、十二指肠及肾的移植物,平均时间为2h。后4次采用UW液灌注和保存的供者器官中,对其中2例供胰进行了保存研究,UW液保存18h的供胰超微结构正常。结论：此方法适合于供者胰、十二指肠及肾的联合获取、修整和保存。     

川芎嗪对犬肾保存的影响

通过犬自体肾移植模型研究了一定浓度的川芎嗪加入ＷＭＯ－１号液对犬肾保存效果的影响。结果表明，单纯ＷＭＯ－１号液保存７２小时和加川芎嗪保存７２小时的肾行自体移植均难存活；加川芎嗪保存４８小时组术后血肌酐的平均值低于单纯ＷＭＯ－１号液保存４８小时组，且血肌酐恢复正常的时间也较单纯ＷＭＯ－１号液组早（Ｐ＜０．０５），说明该实验浓度的川芎嗪不能延长肾保存时间，但有利于移植肾功能的早期恢复。     

大鼠肝脏保存中不同器官保存液对肝细胞凋亡的影响

目的 研究３种目前国内常用的器官保存液对供肝细胞凋亡的影响。方法 分别用ＵＷ液、ＨＣ－Ａ液和ＷＭＯ－１号液灌洗并保存大鼠肝脏,于保存后０、１２、２４ｈ用原位末端标记法检测供肝细胞凋亡情况,并将保存２４ｈ的肝及行大鼠原位全肝移植,观察受者的３ｄ存活率。结果 ３种保存液保存的肝脏均在保存１２ｈ时出现细胞凋亡,ＨＣ－Ａ液级瑟ＷＭＯ－１号液组的凋亡指数（ＡＩ）高于ＵＷ液组（Ｐ〈０．００１）,而ＨＣ－Ａ液组     

Retrograde oxygen persufflation in combination with UW solution enhances adenine nucleotide contents in ischemically damaged rat kidney during cold storage

Retrograde oxygen persufflation (ROP) has been reported to be beneficial to kidney preservation. The purpose of this study was to investigate whether use of ROP during cold storage (CS) with Universita of Wisconsin (UW) solution could ameliorate energy metabolism and functional recovery of ischemically injured rat kidneys and, moreover, to study the particular role of adenosine (ADO) in CS with ROP. Kidneys subjected to 30 min of warm ischemia (WI) were preserved for 24 h in 4°C UW solution with or without ROP and with or without ADO. Measurements of tissue highenergy phosphate levels showed that reduced total adenine nucleotides (TAN) after 30 min of WI further declined during the subsequent CS. In ROP kidneys, however, TAN were less reduced, suggesting that even during CS, TAN can still be regenerated in the injured kidneys when ROP is combined with UW solution. When UW did not contain ADO, regeneration of TAN by ROP was slightly less than in the case of UW with ADO. This indicates that the supply of molecular oxygen is a significant factor in TAN resynthesis during CS. There was no statistically significant difference in survival rate between the ROP and CS group, indicating that an improved energy status is not the sole determinant of functional recovery. We conclude that the gaseous oxygen supply provided by ROP during CS in UW solution ameliorates the energy state of ischemically injured rat kidneys and that exogenous ADO from the UW solution contributes to the improvement of energy metabolism to a limited extent.     

Heart and lung preservation using a new solution; UCLA Formula

Heart and lung preservation is a significant barrier in clinical heart and lung transplantation. In a previous study, we have shown that UCLA Formula, modified from cardioplegic solution, has a favorable effect on lung preservation. In this study, we evaluated the effect of the simultaneous flushing method using UCLA Formula alone on both heart and lung preservation. We conducted six experiments using 18 mongrel dogs, weighing 20–28 kg. In the donor animals, the heart and lungs were each flushed with 500 ml of cold UCLA Formula, using two catheters, one inserted into the ascending aorta and the other into the main pulmonary artery. After the heart and lung block was trimmed, orthotopic cardiac transplantation and single left lung transplantation were independently performed on different recipients following preservation for 4.3 h in the case of the heart and 7.5 h in the case of the lung. Thus, the function of the preserved organs was independently assessed using cardiac output and left ventricular end-diastolic pressure (LVEDP) with constant central venous pressure (CVP) in heart transplantation, and arterial gas analysis and the relationship between inspiratory pressure and expiratory tidal volume in lung transplantation. These measurements were performed before harvesting and 1 h and 4 h after transplantation, After heart transplantation cardiac output showed no significant deterioration. No significant differences in gas analysis and the pressure-volume curve were seen after lung transplantation. In conclusion, the simultaneous flushing method using the UCLA Formula may offer reliable preservation for both heart and lung in preparation for transplantation.