Year 2013 Vol. 21 No 5

GENERAL AND SPECIAL SURGERY

E.V. SHAIDAKOV1, V.L BULATOV1,2, O.I. TSAREV1, S.M. HMELNIKER3, D.A. ROSUHOVSKY1

VIABILITY OF ENDOTHELIUM AT SHORT-TERM STORAGE OF VEIN SEGMENTS IN PERFTORAN AND IN OTHER CONSERVATION MEDIA

FSBE "Scientific Research Institute of Experimental Medicine NWD OF RAMS"1,
Saint-Petersburg,
Saint-Petersburg Institute of Bioregulation and Gerontology, NWD RAMS2,
Saint-Petersburg,
MBE "Municipal clinical hospital 14"3,
Yekaterinburg,
The Russian Federation

Objectives. To compare the indicators of endotheliumum viability at short-term conservation of vein segments in Perftoran, physiological solutionvenous, arterial blood of a patient in vitro.
Methods. Fragments of the great saphenous vein taken intraoperatively during the coronary artery bypass surgery in 58 patients with the ischemic heart disease have been examined. The examined fragments were placed in the test tubes with the equal volume of 10 ml each. 0,9% NaCl solution, heparinized auto-arterial and auto-venous blood and perftoran were used as preservatives. The control brush biopsy of intima was performed immediately after the surgery material taking. The following ones were performed on the 15th and 30th minutes of conservation. 522 membranous specimens of endothelium were examined. They included 58 control specimens, 232 specimens were taken on the 15th minute and 232 on the 30th minute of conservation in the test media. A quantitative calculation of the proportion of endotheliocytes with the signs of necrobiosis was carried out in 5 fields of vision of each membranous specimen.
Results. On the control membranous specimens the median of the proportion of endotheliocytes with signs of necrosis made up 10%, the interquartile range (IQR) 8-13%. On the 15th minute of conservation the minimum proportion of cells with irreversible endothelium changes was observed in the sample with Perftoran: median 18%, interquartile range 16-20%. On the 30th minute of conservation a considerable proportion of necrosis was observed in all specimens, the minimum one was in the sample with Perftoran: median 29%, interquartile range 26-32%; the maximum ones were in auto-venous blood and in physiological solution.
Conclusions. The determinant factor for preservation of vein graft endothelium is considered to be time. The minimum degradation of the venous segment with endothelium was observed immediately after taking a vein graft from the blood flow. If a vein segment is kept for less than 15 minutes Perftoran is recommended to be used as a conservation medium. Conservation for more than 15 minutes is undesirable due to many indicators of endothelium necrosis in all test media.

Keywords: perftoran, venous valve, transplantation, transposition, endothelium, media of conservation, post-thrombotic syndrome
p. 40 44 of the original issue
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Address for correspondence:
197376, Rossiiskaia Federatsiia, g. Sankt-Peterburg, ul. akad. Pavlova, d. 12, FGBU NII Eksperimental'noi Meditsiny SZO RAMN,
e-mail: bulatovvas@gmail.com,
Bulatov Vasilii Leonidovich
Information about the authors:
Shaidakov E.V. MD, professor, deputy director of FSBY "Scientific Research Institute of Experimental Medicine" RAMS, Saint- Petersburg .
Bulatov V.L. a vascular surgeon of clinic of FGBU "Scientific Research Institute of Experimental Medicine" RAMS, Saint- Petersburg, a researcher at the laboratory of biogerontology of Saint-Petersburg Institute of Bioregulation and Gerontology.
Tsarev O.I. MD, a vascular surgeon of clinic of FGBU "Scientific Research Institute of Experimental Medicine" RAMS, Saint- Petersburg .
Khmelniker S.M. MD, deputy chief physician of MBY "Municiple Clinical Hospital 14", Yekaterinburg .
Rosuhovsky D.A. PhD, a head of the department of vascular surgery of clinic of FGBU "Scientific Research Institute of Experimental Medicine" RAMS, Saint- Petersburg.
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