<Original Articles>Effect of Nutritional Status on Hypothermic Liver Perfusion

Abstract

The effect of nutritional status on livers preserved either by simple cold storage or by hypothermic perfusion was studied using isolated rat liver perfusion model. Livers either form fed or fasted rats were preserved for 18 hours by simple cold storage procedure with UW solution, or continuously perfused for 12 hours at 5 or 20°C. Each liver was assessed by one hour normothermic reperfusion following preservation period. Fasted livers in each preservation procedure demonstrated deterioration of hepatocytes more than fed livers assessed by AST, ALT and LDH liberation into perfusate. PNP in the perfusion procedures showed no difference between fasted and fed livers. Slight sinusoidal lining cells changes and vacuolization in hepatocytes were preferential in all groups. Patchy areas of hepatocytic discoloration were often seen in fasted group in each preservation procedure. The nutritional status of hepatic graft is important in both simple storage and continuous perfusion preservation method.

ラット肝灌流モデルをもちいて, 栄養状態が Simpie cold storage 法および, 低温肝灌流保存により保存された肝臓にあたえる影響を調べた. 術前36時間絶食を負荷したラットおよび, 絶食負荷をかけていないラットから採取した肝臓を UW 液をもちいて18 時間保存もしくは, Krebs-Henseleit 液をもちいて5度および20度で12時間持続灌流し, その後37度1時間再灌流し評価した. 絶食を負荷されたラットから採取された肝臓はすべての保存法において, 灌流中への AST, ALT 及び LDH により非絶食群よりも肝細胞障害が強いことが示された. 灌流液中の PNP 値には絶食群, 非絶食群間で差を認めなかった. 組織学的所見においても絶食群は非絶食群にくらべて肝細胞障害が強い傾向が認められた. これらの結果より術前の栄養状態が肝臓保存において強い影響をあたえることが示唆された.