小鼠肝移植中两种肝动脉重建方法的比较

目的比较小鼠肝移植中两种不同肝动脉重建方法的效果。方法应用雄性C57BL/6小鼠建立小鼠肝脏移植模型,随机分为肠系膜上动脉重建组（14对）和腹主动脉重建组（16对）。手术采用异氟醚吸入麻醉。供肝经门静脉灌注4℃威斯康星大学保存液（UW液）。两组小鼠的肝动脉重建分别采用供体肠系膜上动脉或供体肾下腹主动脉与受体腹主动脉端侧吻合两种方法。移植肝血流恢复后重建肝动脉。胆管采用内支架管的方法重建。观察术后2周移植物的存活情况和肝动脉通畅与否。用组织病理学方法检查移植肝的组织形态变化,用免疫组织化学法观察肝脏再生功能。结果术中无小鼠死亡,手术成功率为100%。肠系膜上动脉重建组供体肝动脉游离时间为（12.1±2.5）min,腹主动脉重建组为（17.3±3.1）min,比较差异有统计学意义（P〈0.05）。腹主动脉重建组肝动脉吻合时间为（14.5±2.9）min,肠系膜上动脉重建组相应为（12.4±3.3）min,比较差异无统计学意义（P〉0.05）。肠系膜上动脉重建组移植物术后2周存活率为93%（1只死于吻合口血栓形成）,腹主动脉重建组为100%。肠系膜上动脉重建组术后2周肝动脉通畅率为86%,腹主动脉重建组为100%。组织病理学检查示两组的移植肝组织正常,肝脏再生反应不明显。结论小鼠肝移植中,与应用肠系膜上动脉重建比较,应用腹主动脉吻合重建肝动脉的效果更好且安全,建议首选供受体腹主动脉吻合重建小鼠肝动脉的方法。

Comparison of two reconstruction methods of hepatic artery in mouse liver transplantation

Objective To compare the effect of two different methods to reconstruct hepatic artery in mouse liver transplantation.Methods A model of mouse liver transplantation using male C57BL/6 was established.The mice were randomly divided into 2 groups：superior mesenteric artery reconstruction group（n=14）and abdominal aorta reconstruction group（n=16）.All operations were performed under anesthesia by isoflurane inhalation.The donor liver was flushed through the portal vein with 4 ℃ cold University of Wisconsin（UW）solution.The two applied methods for hepatic artery reconstruction in mice were end-to-side anastomosis of superior mesenteric artery or infrarenal abdominal aorta from donor to abdominal aorta of the recipient.The hepatic artery was reconstructed after blood flow in the liver graft was restored.The bile duct was reconnected through an intraluminal stent.The survival rate of each group and hepatic arterial patency in 2 weeks were followed up.Pathology showed the morphological changes of the liver tissues,and liver regeneration was examined by immunohistochemistry.Results There was no death during operation and the success rate of liver transplantation was 100 %.The dissection time of donor hepatic artery in the superior mesenteric artery reconstruction group was about（12.1±2.5）min and（17.3±3.1）min in the abdominal aorta reconstruction group.There was significant difference between the two groups（P0.05）.The anastomosis time of hepatic artery took（12.4±3.3）min in the superior mesenteric artery reconstruction group,while this procedure took（14.5±2.9）min in the abdominal aorta reconstruction group.There was no significant difference in the hepatic artery anastomosis between the two groups（P0.05）.Graft survival in the mesenteric artery reconstruction group was 93 %（one died of anastomotic thrombosis）and 100 % in the abdominal aorta group at 2 weeks after operation.Hepatic arterial patency in the superior mesenteric artery reconstruction group was 86 % and 100 % in the aortic group at 2 weeks after transplantation.The liver grafts showed normal histology appearance.Conclusion Compared with superior mesenteric artery reconstruction,arterial reconstruction of abdominal aorta between donors and recipients has a high rate of artery patency and safety in mouse liver transplantation.Thus,abdominal aorta reconstruction method between donor and recipient is safe and recommended.