人胰腺移植体内、外分泌部的血管变化

六例人胰腺移植体经UW-Belzers溶液灌注后24小时,每例均观察到内、外分泌部的毛细血管发生显著的改变,这种变化随保存期限而不同。在所采用的各种研究方法中,包括半薄切片、血管腐蚀标本、扫描电镜及透射电镜标本均观察到最初内皮肿胀常伴有血管体积缩小,其后部分内皮细胞质脱落入血管腔,毛细血管小孔数量增加,整个血管呈现退行性变化。在经复苏抢救的胰腺移植体,存在持续的前损伤,早在14小时即呈现明显的血管外渗出,36小时后程度加剧。因此,为了防止可能出现的并发症,此种移植体不宜采用。在通常情况下UW-Belzers溶液对胰腺移植体的保存期限为24小时,超出这一界限则难以充分地再血管化。

VASCULAR CHANGES IN THE EXO- AND ENDOCRINE REGION OF HUMAN PANCREAS TRANSPLANTS

Distinct changes in the capillary vessels of the exocrine as well as the endocrine pancreas could be demonstrated in six human pancreas transplants as early as 24 h following perfusion with UW-BELZERS-solution in dependence on the duration of conservation. Initially, an oedematous swelling of the endothelium often associated with a marked reduction in volume was observed in each case using various procedures such as semi-thin sections, corrosion cast specimens and freeze-fracture preparations both from scanning as well as transmission electron microscopy studies. Sloughing of the endothelium into the free lumen of the vessel which occurs later, finally followed by an increase in the number of pores complete the degenerative changes to the vessels. Transplants from donors with case histories of reanimation are persistently predamaged and show marked extravasates as early as 14 h and to a much greater extent after 36 h and thus should not be used in order to avoid grave foreseable complications. A conservation period of 24 h after organ removal using UWBELZERS solution even under "normal conditions" appears to set a transplantation limit, beyond which sufficient revascularisation cannot be expected.