摘要
目的:探究体外保存时间和UW液温度对供体猪心组织结构的影响。方法:按照临床上现行的供体心脏标准获取流程获取18头中华小型猪的心脏,分别用21℃、4℃和-4℃的UW液在体外保存供体猪心;每一温度下,分别保存供体猪心3 h、6 h和9 h(每种保存条件下保存2个猪心)。然后对体外保存后的猪心进行组织取材,通过苏木素-伊红(HE)染色评估心肌组织内炎症细胞数量、水肿和坏死的心肌细胞数量。结果:HE染色显示,在21℃的UW液中保存3 h时,猪心心肌细胞即出现明显的细胞水肿。在-4℃的UW液中保存3 h时,猪心心肌细胞间的距离已经增大。在4℃的UW液中保存6 h时,猪心心肌细胞已经出现坏死,保存9 h时坏死更加明显。结论:体外保存时间延长可加重供体心脏的缺血性损伤。用21℃和-4℃的UW液静态保存心肌,均不利于心肌组织和细胞结构的维持。在4℃的UW液中静态保存3 h内,猪心不会出现明显的心肌细胞坏死,但保存超过6 h时心肌细胞会出现明显的缺血性损害。因此,在临床工作中,应尽量缩短供体心脏的体外转运时间,并使之一直保存于0℃以上的合适低温范围内。
Objectives: To explore the impacts of heart preservation time and temperature on the myocardial structure of Chinese miniature pigs and to provide basic scientific evidence for the selection of ideal heart preservation temperature and time.Methods: The hearts of 18 Chinese miniature pigs were obtained according to the current clinical standard procedure of donor heart acquisition. Donor pig hearts were preserved in UW solutions at three different temperatures(21°C, 4°C, and-4°C). At each temperature, donor hearts were preserved for three different time(3 h, 6 h, and 9 h, n=2 for each condition).Samples were obtained from the myocardium of the left anterior ventricular wall of pig hearts. Hematoxylin-eosin(HE)staining was conducted to investigate the impacts of different preservation time and temperature on the structure of pig myocardium.Results: HE staining showed that the cardiomyocyte edema emerged when pig heart was preserved in 21℃ UW solution for 3 h, and the distance between the cardiomyocytes increased after heart preservation in-4℃ UW solution for 3 h.Myocardial necrosis was visible after heart preservation in 4℃ UW solution for 6 h, and it became more obvious after preservation for 9 h.Conclusions: Prolongation of the preservation time may aggravate the ischemic injury of the heart. Either 21℃ or-4℃UW solution is not suitable for the maintenance of heart tissue and cell structure. Significant ischemic damage does not happen after preservation in 4℃ UW for 3 h, but ischemic damage will happen after preservation in 4℃ UW for 6 h. Therefore, it is essential to shorten the transportation time of donor heart and keep the heart under an appropriate low temperature above 0℃in clinical work.
作者
王翔宇
宋江平
舒松仁
任杰
郑哲
胡盛寿
马艳
WANG Xiangyu;SONG Jiangping;SHU Songren;REN Jie;ZHENG Zhe;HU Shengshou;MA Yan(Nursing Department of the Operating Theater,National Center for Cardiovascular Diseases and Fuwai Hospital,CAMS and PUMC,Beijing(100037),China)
出处
《中国循环杂志》
CSCD
北大核心
2022年第1期89-93,共5页
Chinese Circulation Journal
基金
中国医学科学院阜外医院护理科研基金(2017-F18-ZX)。
关键词
心脏移植
UW液
保存温度
外置时间
病理
heart transplantation
UW solution
preservation temperature
preservation time
pathology
