冷缺血对大鼠小体积肝移植肝再生的影响

目的探讨冷缺血对大鼠小体积肝移植术后肝再生的影响.方法本组在2002年9月～2004年8月利用大鼠肝总量30%原位肝移植模型,实验分为肝总量70%肝切除组(C组)和冷缺血1、3、5 h组(E1、E2、E3组),观察1w生存率及肝重量/受体原肝重量比值(EGW/RLW),并检测术后1、2、3、7d肝细胞增殖活性及肝组织学变化.结果E1组1w生存率及EGW/RLW分别达100%和95%,均明显高于E2、E3组(P均＜0.05);E1、E 、E3组均于术后2d达到增殖高峰,其中E1组峰值显著高于E2、E3组(P＜0.001),且与C组峰值无差异(P＞0.05);组织学检查见E1组肝细胞核分裂明显活跃.结论冷缺血1 h的小体积供肝和70%肝切除后肝脏具有同样的增殖活性,仅增殖高峰稍晚;冷缺血超过3h严重影响小体积供肝的再生能力和受者的存活率.

Influence of cold ischemia on rat liver regeneration after small-for-size liver transplantation

Objective To explore the effect of cold ischemia on regeneration of small-for-size liver grafts. Methods From September 2002 to August 2004 30% orthotopic liver transplantation (30%OLT)was performed in a syngeneic strain combination. Cold ischemic time of the grafts was set to 1,3 and 5 hours,respectively (Experimental group, E1, E2,E3). The 1-week survival rates as well as graft weight to recipient liver weight ratios (EGW/RLW)were assessed.The proliferative rate of the small-for-size liver grafts were evaluated by Bromodeoxyuridine (BrdU) incorporation method on postoperative day (POD)1, 2,3 and 7,respectively,and compared with those of the remnant liver after 70% partial hepatectomy (Group C). The morphological changes were also observed. Results The 1-week survival rate and EGW/RLW of Group E1 were reached 100% and 95%,respectively, which were significantly higher than those of Group E2 and E3(P all<0.05). Although the proliferative rates of all the experimental groups peaked on POD 2, the peak level of Group E1 showed no difference while compared to that of Group C(P>0.05),but it was significantly higher than those of Group E2 and E3 (P all< 0.001). Histological analysis also revealed a higher number of mitosis in Group E1 on POD 2 and 3.Conclusion The small-for-size liver grafts in 1-hour cold ischemia are capable of regeneration similar to the situation following 70% partial hepatectomy, with a slightly postponed time course. Duration of cold ischemia over 3 hours is associated with impaired regeneration and reduced survival rate.