Abstract:
Objective To compare the preservation quality of intestinal grafts from donors of donation after cardiac death (DCD) and cadaveric donors.
Methods Quality of intestinal grafts from 7 cadaveric donors(group N) and 7 DCD donors(group DCD) in Beijing from 2013 to 2014 was evaluated. The grafts were preserved after perfusion and resection, and then intestinal tissue was collected 30 min and 6 h later. Meanwhile, histopathological examination and intestinal graft injury score (Chiu's integral method) were performed. The content of malondialdehyde (MDA) in intestinal tissue was detected by thiobarbituric acid assay, and the apoptosis of intestinal mucosa cells was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) method.
Results Intestinal graft injury scores for group N and DCD were (1.46±0.81) and (1.76±0.21) respectively at 30 min after preservation, and (3.86±0.42) and(4.17±0.71), respectively at 6 h after preservation(both in P > 0.05). Compared with the preservation of 30 min, intestinal graft injury scores increased significantly in both groups at 6 h after preservation (both in P < 0.05). The contents of MDA in intestinal tissue of the small intestinal graft in group N and DCD were(100±10)pmol/mg and (110±13) pmol/mg, respectively at 30 min after preservation (P > 0.05), and (170±18) pmol/mg and (310±29) pmol/ mg, respectively at 6 h after preservation, of which the difference was statistically significant between the two groups at the same time(P < 0.05). Compared with the preservation of 30 min, the contents of MDA increased significantly in both groups at 6 h after preservation (both in P < 0.05). The number of apoptotic intestinal mucosal cells in small intestinal grafts for group N and DCD was (9.78±2.56) and (15.78±2.84), respectively at 30 min after preservation (P > 0.05), and (31.32±1.38) and (53.42±1.95), respectively at 6 h after preservation, of which the difference was statistically significant between the two groups (P < 0.05). Compared with the preservation of 30 min, the number of apoptotic intestinal mucosal cells in small intestinal grafts increased significantly in both groups at 6 h after preservation(P < 0.05).
Conclusions Preservation quality of small intestinal grafts in DCD donors is roughly equivalent to that in traditional cadaveric donors, which suggests that small intestinal grafts in DCD donors may be used in clinical intestinal transplantation.