大鼠肝移植供肝热缺血时间与胆道损伤的关系

目的 探讨大鼠心源性死亡(DCD)供肝不同的热缺血时间与胆道缺血再灌注损伤的关系.方法 采用无肝素化的大鼠DCD供体肝移植模型,按供肝的热缺血时间分为0 min(WI0),10 min(WI10)、15 min(WI15)3组,每组36对大鼠.术后动态观察大鼠胆道病理改变及其并发症、肝功能指标,最后统计总体生存率.结果 供肝热缺血小于10 min时,术后胆道病理改变较轻且为可逆性改变,肝功能恢复较快;供肝热缺血时间为15 min时,术后胆道病理改变较重且为不可逆性改变,肝功能恢复延迟;3组胆道并发症的发生率差异有统计学意义(5.56%比8.33%比16.67%,P＜0.05).WI0组和WI10组的大鼠术后4周生存率差异无统计学意义(83.33%比77.78%,P＞0.05),而与WI15组比较4周生存率的差异有统计学意义(83.33%比58.33%,77.78%比58.33%,P＜0.05).结论 无肝素化的大鼠DCD供肝热缺血时间超过15 min时,移植术后胆道损伤明显,可导致不可逆改变.

The relationship between different ischemia time of non-heart beating liver graft and bile duct ischemia/reperfusion in rat liver transplantation

Objective To elucidate the relationship between different ischemia time of Donation after Cardiac Death (DCD) liver graft and bile duct ischemia/reperfusion in rat liver transplantation. Methods We chose improved rat liver transplantation mold for the research. The rats were divided into three groups by different warm ischemia time ( WI), such as,0 min ( WI0, n = 36), 10 min ( WI10, n = 36 ), 15 min ( WI5, n = 36). We analyzed the recipient survival rate, biliary complication, liver function and pathology after operation in the three groups. Results There were significantly differences in the WI0, WI10 and WI15 group in biliary complication (5.56% vs 8.33% vs 16.67% ,P ＜0.05). When ischemia time was in 10min,the pathology change is littler and the liver function recover faster than WI15 group. The change was recoverable in 10min but not above 15min. There were no difference between WI0 and WI10 group in four week's survival rate ( 83.33% vs 77.78%, P ＞ 0.05 ). There were significant differences between WI15 and the first two groups in survival rate ( 83.33% vs 58.33% ,77.78% vs 58.33%, P ＜ 0.05 ).Conclusion When the ischemia time of DCD liver graft being above 15 min,the bile duct cell was damaged remarkably and show irreversible change.