生物能量和细胞因子分析可能有助于拯救更多的DCD肝脏用于移植
Julia Hofmann1, Andras T Meszaros1, Madita L Buch1
1organLife Organ Regeneration Center of Excellence and Daniel Swarovski Laboratory, Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria.
International journal of molecular sciences
|June 10, 2023
概括
在循环死亡 (DCD) 之后捐赠的肝脏显示线粒体功能受损,但在正常热机器输液 (NMP) 期间恢复,与脑死亡 (DBD) 捐赠者肝脏的表现类似. 这表明扩大DCD器官的使用与新的质量评估标准.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 移植免疫学 移植免疫学
- 线粒体生理学线粒体生理学
背景情况:
- 肝移植很大程度上依赖于脑死亡 (DBD) 的捐赠者,但器官短缺需要考虑在循环死亡 (DCD) 器官后进行捐赠.
- 常温机器输液 (NMP) 可以恢复器官的活力,并促进移植前的质量评估.
- DCD器官可能特别受益于NMP,因为血液循环停止的潜在初始侮辱.
研究的目的:
- 在NMP期间比较DBD和DCD肝脏的生物能量功能和炎症反应.
- 评估NMP在恢复DCD肝脏中的线粒体功能的有效性.
- 通过分析其在NMP下的表现来评估DCD器官移植的潜力.
主要方法:
- 高分辨率呼吸计用于评估DBD和DCD肝脏组织活检中的线粒体功能.
- perfusate生物标志物和组织学被分析以评估器官质量.
- 在NMP期间测量了 perfusate 中的细胞因子表达水平 (IL-1β,IL-5,IL-6).
- 在静态冷藏和NMP期间对DBD和DCD肝脏性能进行比较分析.
主要成果:
- 组织学和透生物标志物在DBD和DCD肝脏之间没有显著差异.
- 与DBD肝脏相比,DCD肝脏在静态冷藏后表现出更大的线粒体功能障碍.
- 在DCD肝脏中,NMP成功地恢复了线粒体功能,导致与DBD肝脏的性能相当.
- 在NMP结束时,在DCD肝 perfusate中观察到IL-1β,IL-5和IL-6的升高水平.
结论:
- DCD肝脏最初表现出线粒体功能障碍,但在NMP时显示出显著的恢复.
- NMP是评估和潜在地提高DCD供体肝脏的生存能力的宝贵工具.
- 这些发现支持重新考虑用于移植的DCD器官,并制定新的捐赠器官质量评估标准,包括生物能功能和细胞因子概况.
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