猪胰、十二指肠及肾联合移植的实验研究

目的 研究猪胰、十二指肠及肾联合移植早期自然排斥反应的监测指标和组织病理改变。方法 ３０头猪作为供受体，血管吻合采用移植物的腹主动脉段和门静脉与受体肾以下腹主动脉及下腔静脉分别吻合，十二指肠与受体膀胱侧侧吻合，输尿管置管外引流。监测受体的空腹血糖、尿淀粉酶和移植肾尿量，并观察移植物的病理变化。结果 １５头受体中，１３头获得移植成功。排斥反应发生时，尿淀粉酶的改变明显先于空腹血糖和移植尿肾尿量的变化

Experimental study on combined pancreaticoduodenal and kidney allotransplantation in pigs

Objectives To study the markers of early rejection and pathological change in simultaneous pancreaticoduodenal and kidney transplantation (SPKT). Methods Thirty hybrid pigs were used as donors and recipients. A renoportal end to end anastomosis between the left renal vein and the distal end of portal vein was performed. Two vascular end to side anastomoses between the donor portal vein and recipient inferior vena cava, and between the donor aortic segment including the celiac, superior mesenteric, and left renal arteries and recipient abdominal aorta were carried out. Pancreas exocrine secretion drainage was established with duodenocystostomy. The ureterostomosis of the graft was performed. Urine amylase concentration, fast blood sugar and urine volumes of kidney allograft were monitored, and pathological change of graft was observed. Results Of 15 recipients, 2 cases died of disturbance of internal environment and anastomotic bleeding, respectively. Satisfactory results were obtained in the remaining 13 recipients. The change of urine amylase concentration was prior to those of fast blood sugar and urine volumes of the kidney allograft. The degree of rejection of kidney allograft was more severe than that of pancreas and duodenum allograft.Conclusions Urine amylase was the early marker of acute rejection in SPKT with bladder drainage of pancreatic exocrine secretion. The pathological change of kidney allograft was most significant in SPKT.