vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2024-4-189-200vtio-1872Research ArticleЭкспериментальные исследованияЭкспериментальные исследования нового комбинированного раствора на основе декстрана-40 на модели мелких лабораторных животныхExperimental study of a new dextran-40-based combined solution on a small laboratory animal modelГрудининН. В.GrudininN. V.

Грудинин Никита Владимирович

123182, Москва, ул. Щукинская, д. 1.

Тел. (903) 805-63-58

Nikita Grudinin

1, Shchukinskaya str., Moscow, 123182

Phone: (903) 805-63-58

zbignev.religa@mail.ruБогдановВ. К.BogdanovV. K.

Москва

Moscow

bogdanovv@bk.ruПашковИ. В.PashkovI. V.

Москва

Moscow

https://orcid.org/0000-0003-0619-5411ЕсиповаО. Ю.EsipovaO. Yu.

Москва

Moscow

КулешовА. П.KuleshovA. P.

Москва

Moscow

МожейкоН. П.MozheikoN. P.

Москва

Moscow

ВолковаЕ. А.VolkovaE. A.

Москва

Moscow

ГотьеС. В.GautierS. V.

Москва

Moscow

gautier@list.ruФГБУ «Национальный медицинский исследовательский центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава РоссииРоссияShumakov National Medical Research Center of Transplantology and Artificial OrgansRussian FederationФГБУ «Национальный медицинский исследовательский центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава России; ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Минздрава России (Сеченовский университет)РоссияShumakov National Medical Research Center of Transplantology and Artificial Organs; Sechenov UniversityRussian Federation202406092024264189200Copyright © Грудинин Н.В., Богданов В.К., Пашков И.В., Есипова О.Ю., Кулешов А.П., Можейко Н.П., Волкова Е.А., Готье С.В., 20252025Грудинин Н.В., Богданов В.К., Пашков И.В., Есипова О.Ю., Кулешов А.П., Можейко Н.П., Волкова Е.А., Готье С.В.Grudinin N.V., Bogdanov V.K., Pashkov I.V., Esipova O.Y., Kuleshov A.P., Mozheiko N.P., Volkova E.A., Gautier S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.transpl.ru/vtio/article/view/1872Актуальность

Актуальность. Существующий дефицит донорских органов остается нерешенной проблемой в области трансплантологии. Особенно остро это ощущается в таком прогрессивном направлении, как трансплантация легких. Применение перфузионных технологий позволило значительно расширить возможности развития экстракорпоральных систем для реабилитации донорских органов, но до сих пор остается актуальным поиск оптимальных перфузионных и консервирующих растворов.

Цель

Цель: оценить эффективность разработанного раствора для консервации и нормотермической ex vivo перфузии легких (EVLP), а также провести сравнительный анализ с официнальным раствором для процедуры EVLP.

Материалы и методы

Материалы и методы. Проведены экспериментальные исследования на моделях мелких животных. Все животные были разделены на 2 группы: контрольную и экспериментальную. Этапы исследования состояли из эксплантации донорских легких, статического гипотермического хранения, ex vivo перфузии донорских легких и ортотопической трансплантации левого легкого. Консервация донорских легких проводилась в экспериментальной группе опытным раствором, в группе контроля – Perfadex Plus (XVIVO, Швеция). Период статического гипотермического хранения составлял 10 часов. После ex vivo перфузии выполнялась ортотопическая трансплантация левого легкого, период наблюдения составлял 2 часа, после чего выполняли забор проб крови и участков трансплантированного легкого для морфологического исследования. По завершении эксперимента животное выводилось из эксперимента посредствам обескровливания.

Результаты

Результаты. Респираторный индекс под конец перфузии был статистически значимо выше в экспериментальной группе и составил 434 мм рт. ст. против 394 мм рт. ст. в группе контроля. Показатели легочного сосудистого сопротивления в обеих группах имели динамику к снижению, что является хорошим прогностическим признаком эффективности перфузионных агентов. Легочное сосудистое сопротивление в экспериментальной группе было ниже и составляло 36 дин·с/см–5 против 89 дин·с/см–5 в контрольной группе.

Заключение

Заключение. Разработанный комбинированный раствор на основе декстрана-40 показал свою эффективность как консервирующий агент для статического гипотермического хранения и как перфузионный раствор для EVLP.

Background

Background. Organ shortage remains an unsolved issue in the field of transplantology. It is particularly severe in such a progressive area as lung transplantation. The creation of extracorporeal systems for rehabilitation of donor organs has been made possible by perfusion techniques; however, the search for the best perfusion and preservation solutions remains important.

Objective

Objective: to evaluate the efficacy of the developed solution for preservation and normothermic ex vivo lung perfusion (EVLP), as well as to conduct a comparative analysis with the standard perfusion solution for EVLP.

Materials and methods

Materials and methods. Experimental studies on small animal models were conducted. All animals were divided into 2 groups – control and experimental. The study stages consisted of: procurement of donor lungs, static cold storage, EVLP and orthotopic left lung transplantation. In the experimental group, the lungs were preserved using an experimental solution, while in the control group, they were preserved in PERFADEX® Plus (XVIVO, Sweden). Static cold storage lasted for 10 hours. Orthotopic left lung transplantation was performed after EVLP. The follow-up period was 2 hours, after which blood samples and sections of the transplanted lung were taken for morphological examination. Upon completion of the experiment, the animal was removed from the experiment by exsanguination.

Results

Results. Respiratory index at the end of perfusion was statistically significantly higher in the experimental group (434 mmHg) than that of the control group (394 mmHg). Pulmonary vascular resistance (PVR) in both groups had a downward trend, which is a good prognostic sign of the efficacy of perfusion agents. PVR was lower in the experimental group compared to the control group – 36 versus 89 dynes/sec/cm–5.

Conclusion

Conclusion. The developed combined dextran-40-based solution showed its effectiveness as a preservation agent for static cold storage and as a perfusion solution for EVLP.

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The authors declare that there are no conflicts of interest present.