Resuscitation of ischemically damaged pancreas by the two-layer (University of Wisconsin solution/perfluorochemical) mild hypothermic storage method.
We have shown that 24-hour preservation by a two-layer [University of Wisconsin solution (UW)/perfluorochemical (PFC)] cold storage method at 4 degrees C allowed tissue ATP synthesis and resuscitated canine pancreases subjected to 90 minutes of warm ischemia. The purpose of this study was to examine whether the two-layer (UW/PFC) mild hypothermic storage method at 20 degrees C could shorten a preservation period for recovery of ischemically damaged pancreas and clarify changes of tissue adenine nucleotide metabolism and tissue perfusions. After 90 minutes of warm ischemia, canine pancreas grafts were preserved by the two-layer method and then autotransplanted. Tissue adenine nucleotide levels at the end of preservation and tissue perfusions after reperfusion were measured. Pancreas grafts subjected to 90 minutes of warm ischemia did not survive (0 of 5), without preservation. During a 5-hour preservation by the two-layer cold storage method the grafts did not synthesize enough ATP to repair damaged cell, although tissue perfusions were maintained after reperfusion. Consequently, ischemically damaged pancreases were not resuscitated (0 of 3). However, during 5-hour preservation by the two-layer mild hypothermic storage method, the grafts supplied enough ATP for processes that repair damaged cells, and tissue perfusions were maintained after reperfusion. As a result, ischemically damaged grafts were resuscitated (5 of 5). We conclude that 5-hour preservation by the two-layer mild hypothermic storage method accelerates ATP synthesis, which is essential for repairing damaged cells and protects the vascular microcirculation. This method can resuscitate ischemically damaged pancreas faster and holds promise for pancreas-kidney transplantation from cardiac arrest donors.
Matsumoto
S
S
First Department of Surgery, Kobe University School of Medicine, 7-5-2, Kusunoki-cho, Kobe 650, Japan.
Kuroda
Y
Y
Fujita
H
H
Tanioka
Y
Y
Kim
Y
Y
Sakai
T
T
Hamano
M
M
Suzuki
Y
Y
Ku
Y
Y
Saitoh
Y
Y
D000227:Adenine Nucleotides / Q000032:analysis; D000241:Adenosine; D000255:Adenosine Triphosphate / Q000378:metabolism; D000493:Allopurinol; D000818:Animals; D015925:Cryopreservation; D004285:Dogs; D005260:Female; D005466:Fluorocarbons; D005978:Glutathione; D006085:Graft Survival / Q000502:physiology; D007328:Insulin; D008297:Male; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions; D010179:Pancreas / Q000502:physiology*; D016035:Pancreas Transplantation / Q000502:physiology*; D011887:Raffinose; D015427:Reperfusion Injury / Q000503:physiopathology*
D000227:Adenine Nucleotides; D005466:Fluorocarbons; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; C008805:perfluorodecalin; D000493:Allopurinol; D000255:Adenosine Triphosphate; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose