深低温冻存同种异体血管的临床应用进展
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摘要
深低温冻存是保存同种异体血管的有效方法,此外还可降低同种异体血管的免疫原性,抑制排斥反应。冷冻保护剂可减轻深低温冻存时对同种异体血管的损伤,保护血管。冷冻保护剂可分为渗透性保护剂和非渗透性保护剂,两者联合应用可降低渗透性保护剂的毒性,提高保护效果。临床上较常用的血管移植材料包括自体静脉血管、人造血管以及同种异体血管,其中同种异体血管的效果最好,可用于血管损伤、动脉瘤、心脏病、血液透析通路的建立、器官移植及恶性肿瘤等。
The cryopreservation is an effective way to preserve allografts,which could reduce the immunogenicity and suppress graft rejection. The cryoprotective agents can reduce the damage to allogeneic blood vessels during cryopreservation and protect blood vessels. It can be divided into permeable and non-permeable agents,and the combined application of them can also reduce the toxicity and improve the protective effects. The allograft materials commonly used in clinical practice include autogenous homologous,artificial vessels and allogeneic blood vessels,among which allogeneic blood vessels have the best effect and can be used for vascular injury,aneurysm,heart disease,establishment of hemodialysis pathway,organ transplantation and malignant tumors.
The cryopreservation is an effective way to preserve allografts,which could reduce the immunogenicity and suppress graft rejection. The cryoprotective agents can reduce the damage to allogeneic blood vessels during cryopreservation and protect blood vessels. It can be divided into permeable and non-permeable agents,and the combined application of them can also reduce the toxicity and improve the protective effects. The allograft materials commonly used in clinical practice include autogenous homologous,artificial vessels and allogeneic blood vessels,among which allogeneic blood vessels have the best effect and can be used for vascular injury,aneurysm,heart disease,establishment of hemodialysis pathway,organ transplantation and malignant tumors.
引文
[1]何建平,张树明,朱泽兴.深低温处理在同种异体移植中对组织免疫源性研究进展[J].中国矫形外科杂志,2013,21(9):900-902.
[2]关颖,关国平,林婧,等.小口径人工血管顺应性的影响因素和改善方法[J].材料导报,2014,28(19):125-129.
[3]徐志伟,谭燕,吴昊,等.小口径人工血管支架材料:问题与前景[J].中国组织工程研究,2014,18(3):452-456.
[4] Wingenfeld C,Egli RA,Ganz R,et al. Cryopreservation of osteo-chondral allografts:Dimethyl sulfoxide promotes angiogenesis andimmune tolerance in mice[J]. J Bone Joint Surg Am,2002,84-A(8):1420-1429.
[5] Best BP. Cryoprotectant toxicity:Facts,issues,and questions[J].Rejuvenation Res,2015,18(5):422-436.
[6] Fahy GM,Wowk B. Principles of cryopreservation by vitrification[J].Methods Mol Biol,2015,1257:21-82.
[7]张哲平,张树明.组织深低温冻存中保护剂的应用[J].中国组织工程研究,2013,17(18):3381-3388.
[8] Polge C,Smith AU,Parkes AS. Revival of spermatozoa after vitri-fication and dehydration at low temperatures[J]. Nature,1949,164(4172):666.
[9]初超,侯利民,刘明辉.深低温冷冻技术的研究进展[J].现代生物医学进展,2012,12(19):3766-3769.
[10] Barceló-Fimbres M,Seidel GE Jr. Effects of fetal calf serum,phenazine ethosulfate and either glucose or fructose during in vitroculture of bovine embryos on embryonic development after cryop-reservation[J]. Mol Reprod Dev,2007,74(11):1395-1405.
[11]牟联俊,李楠,韦继红,等.冻融胚胎和冻融囊胚对移植周期和分娩结局影响的比较[J].中国组织工程研究,2014,18(27):4412-4417.
[12] Erdag G,Eroglu A,Morgan J,et al. Cryopreservation of fetal skinis improved by extracellular trehalose[J]. Cryobiology,2002,44(3):218-228.
[13]江玉华,徐林浩,罗宜人,等.海藻糖对低温保存胸骨中bcl-2和bax基因表达的影响[J].中国组织工程研究,2011,15(21):3975-3978.
[14]贾晓明,马彩虹,于瑜,等.海藻糖对低温储存皮肤β1 integrin及活力的影响[J].军医进修学院学报,2008,29(3):206-208.
[15]谢俊峰.深低温保存同种异体血管移植建立游离皮瓣血供的实验研究[D].衡阳:南华大学,2015.
[16]温树正,刘万林,霍洪军,等.同种异体血管移植的实验研究与临床应用[J].中华骨科杂志,1996,16(3):145-147.
[17]姬亚飞,白晨平,李红卫,等.同种异体血管移植的临床应用[J].中国实用医刊,2009,36(3):50-51.
[18] Minz M,Sharma A,Kumar S,et al. Use of autogenous internaliliac artery for bridging the external iliac artery after excision ofAspergillus mycotic aneurysm in renal transplant recipients[J].J Vasc Surg,2011,53(3):802-804.
[19] Cho YP,Kim SC,Kim SA,et al. An idiopathic congenital abdominalaortic aneurysm with impending rupture in a 23-month-old boy[J].J Vasc Surg,2013,57(2):508-510.
[20] Petrunic M,Mestrovic T,Loncaric Y,et al. In situ repair of amycotic suprarenal aortic aneurysm using a cryopreserved aortichomograft and visceral debranching in a patient with spondylodis-citis and left psoas muscle abscess[J]. Ann Thorac CardiovascSurg,2013,19(5):394-398.
[21] Harlander-Locke MP,Harmon LK,Lawrence PF,et al. The use ofcryopreserved aortoiliac allograft for aortic reconstruction in theUnited States[J]. J Vasc Surg,2014,59(3):669-674.
[22] Ross DN,Somerville J. Correction of pulmonary atresia with ahomograft aortic valve[J]. Lancet,1966,2(7479):1446-1447.
[23] Krahn AD,Healey JS,Simpson CS,et al. Anticoagulation ofpatients on chronic warfarin undergoing arrhythmia device surgery:Wide variability of perioperative bridging in Canada[J]. HeartRhythm,2009,6(9):1276-1279.
[24]何菊,李晓锋,杨森.同种异体血管的临床应用现状[J].中华普通外科杂志,2015,30(9):750-752.
[25] Schiller O,Sinha P,Zurakowski D,et al. Reconstruction of rightventricular outflow tract in neonates and infants using valved cryo-preserved femoral vein homografts[J]. J Thorac Cardiovasc Surg,2014,147(3):874-879.
[26] Nappi F,Spadaccio C,Chello M,et al. Impact of structural valvedeterioration on outcomes in the cryopreserved mitral homograftvalve[J]. J Card Surg,2015,29(5):616-622.
[27]孙衍庆,杨能善.同种异体大血管移植治疗小儿复杂先天性心脏病[J].心肺血管病杂志,1994,13(1):6-9.
[28]廖崇先,邱罕凡,陈道中.同种异体带瓣大血管治疗复杂先天性心脏病[J].福建医科大学学报,2000,34(1):27-29.
[29]钟伟强,杨铁城,余林权,等.同种异体血管和人造血管移植制作动静脉内瘘的临床研究[J].中华显微外科杂志,2004,27(2):149-151.
[30]刘声茂,卢雪红,罗萍,等.同种异体血管内瘘与聚四氟乙烯人造血管内瘘的比较[J].中国老年学杂志,2006,26(12):1633-1634.
[31] Ha TY,Kim YH,Chang JW,et al. Clinical outcomes of cryopre-served arterial allograft used as a vascular conduit for hemodialy-sis[J]. J Korean Med Sci,2016,31(8):1266-1272.
[32] Jadlowiec CC,Lavallee M,Mannion EM,et al. Current outcomesand indications for cryopreserved vein allografts in hemodialysisaccess surgery[J]. J Vasc Access,2016,17(1):47-54.
[33]张克明,董家鸿,蔡守旺,等.同种异体静脉在活体右半肝肝移植流出道重建中的作用[J].传染病信息,2010,23(4):214-217.
[34]关兆杰,任秀昀,徐光勋,等.冷冻保存髂静脉用于活体右半肝移植肝中静脉重建[J].中国修复重建外科杂志,2011,25(11):1393-1396.
[35]郑树森,严盛,张启逸,等.胰腺癌扩大切除与血管重建中值得进一步关注的问题[J].中国实用外科杂志,2013,33(9):723-726.
[36]张晓刚,张东,刘昌,等.深低温保存同种异体血管的临床应用[J].北京大学学报(医学版),2015,47(5):891-893.
[37]王伟林,叶松,沈岩,等.同种异体血管移植在联合门静脉切除的胰腺癌根治术中的应用[J].中华普通外科杂志,2016,31(5):365-369.
[38]武峤,韩东冬,郎韧,等.结肠下区动脉入路联合门静脉系统血管切除异体血管置换在根治性胰十二指肠切除术中的应用价值[J].中华消化外科杂志,2017,16(10):1061-1066.
[2]关颖,关国平,林婧,等.小口径人工血管顺应性的影响因素和改善方法[J].材料导报,2014,28(19):125-129.
[3]徐志伟,谭燕,吴昊,等.小口径人工血管支架材料:问题与前景[J].中国组织工程研究,2014,18(3):452-456.
[4] Wingenfeld C,Egli RA,Ganz R,et al. Cryopreservation of osteo-chondral allografts:Dimethyl sulfoxide promotes angiogenesis andimmune tolerance in mice[J]. J Bone Joint Surg Am,2002,84-A(8):1420-1429.
[5] Best BP. Cryoprotectant toxicity:Facts,issues,and questions[J].Rejuvenation Res,2015,18(5):422-436.
[6] Fahy GM,Wowk B. Principles of cryopreservation by vitrification[J].Methods Mol Biol,2015,1257:21-82.
[7]张哲平,张树明.组织深低温冻存中保护剂的应用[J].中国组织工程研究,2013,17(18):3381-3388.
[8] Polge C,Smith AU,Parkes AS. Revival of spermatozoa after vitri-fication and dehydration at low temperatures[J]. Nature,1949,164(4172):666.
[9]初超,侯利民,刘明辉.深低温冷冻技术的研究进展[J].现代生物医学进展,2012,12(19):3766-3769.
[10] Barceló-Fimbres M,Seidel GE Jr. Effects of fetal calf serum,phenazine ethosulfate and either glucose or fructose during in vitroculture of bovine embryos on embryonic development after cryop-reservation[J]. Mol Reprod Dev,2007,74(11):1395-1405.
[11]牟联俊,李楠,韦继红,等.冻融胚胎和冻融囊胚对移植周期和分娩结局影响的比较[J].中国组织工程研究,2014,18(27):4412-4417.
[12] Erdag G,Eroglu A,Morgan J,et al. Cryopreservation of fetal skinis improved by extracellular trehalose[J]. Cryobiology,2002,44(3):218-228.
[13]江玉华,徐林浩,罗宜人,等.海藻糖对低温保存胸骨中bcl-2和bax基因表达的影响[J].中国组织工程研究,2011,15(21):3975-3978.
[14]贾晓明,马彩虹,于瑜,等.海藻糖对低温储存皮肤β1 integrin及活力的影响[J].军医进修学院学报,2008,29(3):206-208.
[15]谢俊峰.深低温保存同种异体血管移植建立游离皮瓣血供的实验研究[D].衡阳:南华大学,2015.
[16]温树正,刘万林,霍洪军,等.同种异体血管移植的实验研究与临床应用[J].中华骨科杂志,1996,16(3):145-147.
[17]姬亚飞,白晨平,李红卫,等.同种异体血管移植的临床应用[J].中国实用医刊,2009,36(3):50-51.
[18] Minz M,Sharma A,Kumar S,et al. Use of autogenous internaliliac artery for bridging the external iliac artery after excision ofAspergillus mycotic aneurysm in renal transplant recipients[J].J Vasc Surg,2011,53(3):802-804.
[19] Cho YP,Kim SC,Kim SA,et al. An idiopathic congenital abdominalaortic aneurysm with impending rupture in a 23-month-old boy[J].J Vasc Surg,2013,57(2):508-510.
[20] Petrunic M,Mestrovic T,Loncaric Y,et al. In situ repair of amycotic suprarenal aortic aneurysm using a cryopreserved aortichomograft and visceral debranching in a patient with spondylodis-citis and left psoas muscle abscess[J]. Ann Thorac CardiovascSurg,2013,19(5):394-398.
[21] Harlander-Locke MP,Harmon LK,Lawrence PF,et al. The use ofcryopreserved aortoiliac allograft for aortic reconstruction in theUnited States[J]. J Vasc Surg,2014,59(3):669-674.
[22] Ross DN,Somerville J. Correction of pulmonary atresia with ahomograft aortic valve[J]. Lancet,1966,2(7479):1446-1447.
[23] Krahn AD,Healey JS,Simpson CS,et al. Anticoagulation ofpatients on chronic warfarin undergoing arrhythmia device surgery:Wide variability of perioperative bridging in Canada[J]. HeartRhythm,2009,6(9):1276-1279.
[24]何菊,李晓锋,杨森.同种异体血管的临床应用现状[J].中华普通外科杂志,2015,30(9):750-752.
[25] Schiller O,Sinha P,Zurakowski D,et al. Reconstruction of rightventricular outflow tract in neonates and infants using valved cryo-preserved femoral vein homografts[J]. J Thorac Cardiovasc Surg,2014,147(3):874-879.
[26] Nappi F,Spadaccio C,Chello M,et al. Impact of structural valvedeterioration on outcomes in the cryopreserved mitral homograftvalve[J]. J Card Surg,2015,29(5):616-622.
[27]孙衍庆,杨能善.同种异体大血管移植治疗小儿复杂先天性心脏病[J].心肺血管病杂志,1994,13(1):6-9.
[28]廖崇先,邱罕凡,陈道中.同种异体带瓣大血管治疗复杂先天性心脏病[J].福建医科大学学报,2000,34(1):27-29.
[29]钟伟强,杨铁城,余林权,等.同种异体血管和人造血管移植制作动静脉内瘘的临床研究[J].中华显微外科杂志,2004,27(2):149-151.
[30]刘声茂,卢雪红,罗萍,等.同种异体血管内瘘与聚四氟乙烯人造血管内瘘的比较[J].中国老年学杂志,2006,26(12):1633-1634.
[31] Ha TY,Kim YH,Chang JW,et al. Clinical outcomes of cryopre-served arterial allograft used as a vascular conduit for hemodialy-sis[J]. J Korean Med Sci,2016,31(8):1266-1272.
[32] Jadlowiec CC,Lavallee M,Mannion EM,et al. Current outcomesand indications for cryopreserved vein allografts in hemodialysisaccess surgery[J]. J Vasc Access,2016,17(1):47-54.
[33]张克明,董家鸿,蔡守旺,等.同种异体静脉在活体右半肝肝移植流出道重建中的作用[J].传染病信息,2010,23(4):214-217.
[34]关兆杰,任秀昀,徐光勋,等.冷冻保存髂静脉用于活体右半肝移植肝中静脉重建[J].中国修复重建外科杂志,2011,25(11):1393-1396.
[35]郑树森,严盛,张启逸,等.胰腺癌扩大切除与血管重建中值得进一步关注的问题[J].中国实用外科杂志,2013,33(9):723-726.
[36]张晓刚,张东,刘昌,等.深低温保存同种异体血管的临床应用[J].北京大学学报(医学版),2015,47(5):891-893.
[37]王伟林,叶松,沈岩,等.同种异体血管移植在联合门静脉切除的胰腺癌根治术中的应用[J].中华普通外科杂志,2016,31(5):365-369.
[38]武峤,韩东冬,郎韧,等.结肠下区动脉入路联合门静脉系统血管切除异体血管置换在根治性胰十二指肠切除术中的应用价值[J].中华消化外科杂志,2017,16(10):1061-1066.