腎灌流保存におけるviabilityに関する研究 ： ことに灌流液中の諸酵素について

Abstract

Based upon a well-acknowledged concept that the viability of a preserved organ exclusively depends upon the maintainance of mitochondrial function, this study was performed using variable damaged dog kidney by warm ischemic intervention from 0 to 120 minutes (warm ischemic time, WIT). The isolated kidney subjected to WIT was perfused with cold fibrinogen-free plasma on the machine for 18 hours and reautotransplanted for the judgment of the graft function. During preservation, several common enzymes, such as LDH, GOT, GPT, Al-P and CPK were determined at 3 occasions, e. g. at 3 hrs, 6 hrs and 18 hrs of preservation. With regard to LDH, the isozyme pattern was analysed as well as total activity. All data for each enzyme was surveyed in the relationship with WIT and interpreted focusing on its relibility as a parameter of viability based on a function of re-autotransplanted graft. Consequently, the following results were confirmed in the work. LDH and LDH isozyme were the most sensitive according to both preservation time and length of WIT in several enzymes which escaped into the perfusate from preserved kidney after warm ischemia. Though GOT in perfusate was not so sensitive as LDH and LDH isozyme, GOT elevated in proportion to the length of WIT. But the other enzymes in the perfusate did not so elevate remarkably compared to WIT 0 and 120 minutes as control groups. Comparing the results between the graft function and the LDH activity in wash-out sample, author decided that LDH activity value was 12 I.U/g (graft weight) as the critical value in wash-out sample. Thus, an analysis of the LDH activity and LDH isozyme in the wash-out sample can provide considerable and precise information about kidney viability as a graft.