Document Detail

Tolerance of human placental tissue to severe hypoxia and its relevance for dual ex vivo perfusion.
MedLine Citation:
PMID:  19064287     Owner:  NLM     Status:  MEDLINE    
In the dual ex vivo perfusion of an isolated human placental cotyledon it takes on average 20-30 min to set up stable perfusion circuits for the maternal and fetal vascular compartments. In vivo placental tissue of all species maintains a highly active metabolism and it continues to puzzle investigators how this tissue can survive 30 min of ischemia with more or less complete anoxia following expulsion of the organ from the uterus and do so without severe damage. There seem to be parallels between "depressed metabolism" seen in the fetus and the immature neonate in the peripartum period and survival strategies described in mammals with increased tolerance of severe hypoxia like hibernators in the state of torpor or deep sea diving turtles. Increased tolerance of hypoxia in both is explained by "partial metabolic arrest" in the sense of a temporary suspension of Kleiber's rule. Furthermore the fetus can react to major changes in surrounding oxygen tension by decreasing or increasing the rate of specific basal metabolism, providing protection against severe hypoxia as well as oxidative stress. There is some evidence that adaptive mechanisms allowing increased tolerance of severe hypoxia in the fetus or immature neonate can also be found in placental tissue, of which at least the villous portion is of fetal origin. A better understanding of the molecular details of reprogramming of fetal and placental tissues in late pregnancy may be of clinical relevance for an improved risk assessment of the individual fetus during the critical transition from intrauterine life to the outside and for the development of potential prophylactic measures against severe ante- or intrapartum hypoxia. Responses of the tissue to reperfusion deserve intensive study, since they may provide a rational basis for preventive measures against reperfusion injury and related oxidative stress. Modification of the handling of placental tissue during postpartum ischemia, and adaptation of the artificial reperfusion, may lead to an improvement of the ex vivo perfusion technique.
H Schneider
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Publication Detail:
Type:  In Vitro; Journal Article; Review     Date:  2008-12-06
Journal Detail:
Title:  Placenta     Volume:  30 Suppl A     ISSN:  0143-4004     ISO Abbreviation:  Placenta     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-02-23     Completed Date:  2009-05-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006349     Medline TA:  Placenta     Country:  England    
Other Details:
Languages:  eng     Pagination:  S71-6     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Universitäts-Frauenklinik, Insel Spital, Berne, Switzerland.
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MeSH Terms
Anoxia / physiopathology*
Basal Metabolism
Energy Metabolism / physiology
Hibernation / physiology
Oxidative Stress / physiology
Placenta / physiopathology*
Reperfusion Injury / physiopathology

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