返回Google圖書搜尋

Ex-vivo Study of Hepatic Microcirculation and Flow Dynamics During Extended Hypothermic Machine Perfusion Preservation

出版	University of North Carolina at Charlotte, 2003
URL	http://books.google.com.hk/books?id=tCi_nQEACAAJ&hl=&source=gbs_api

註釋Hypothermic machine perfusion (HMP) preservation has the potential to relieve the current donor liver crisis by an extended and improved preservation. HMP may be a better method to preserve livers, as has already been proven with the kidney. However, the current HMP protocols on livers have not been successful during extended preservation and the major cause of preservation injury remains unknown. To address the mechanism of preservation injury during an extended HMP (24-hours), we conducted an intravital microscopy and confocal microscopy studies to visualize and analyze the sinusoidal perfusion, flow dynamics and endothelial cells (ECs) structure during 24-hour HMP with the modified cold University of Wisconsin (UW) solution. Our flow dynamics analysis and sinusoidal perfusion visualization studies utilizing Fluorescein Isothiocynate (FITC) labeled albumin and red blood cells (RBCs) indicated a heterogeneous flow pattern with regions of red blood cell stasis after 24-hour HMP. The histological study indicated rounded EC structure after 24-hour HMP. A confocal microscopy study of DiI acetylated low-density lipoprotein (acLDL) labeled ECs indicated that after 24-hour HMP, rounded ECs were directly responsible for vasoconstriction, causing red blood cell stasis, resulting in a heterogeneous perfusion. Our study was further extended to examine the effect of 24-hour HMP, when a range of shear stress is applied. These studies suggest that EC rounding occurred at all the experimental shear rates during 24-hour HMP, causing obstruction to the flow inside the sinusoids. As a result, a heterogeneous flow pattern, red cell stasis and interstitial edema occur, which may lead to failure of these tissues during extended HMP.