大鼠原位肝移植制作过程中常见失败原因分析及处理策略

目的：分析大鼠位肝移植制作过程中常见失败原因及总结相应的处理策略。
方法：历时10个月，采用改良Kamada二袖套法制作大鼠原位肝移植模型150例。将每完成50例作为1个实验阶段，分早、中、后期3个阶段对失败原因进行分析，总结经验。
结果：大鼠原位肝移植常见失败原因在早期阶段主要以气胸（5.8%）,术中出血（10.6%）,无肝期过长（50.4%）为主；中、后期主要以肝上下腔静脉吻合失败（21.0%），无肝期过长（20.6%），门静脉及肝下下腔静脉袖套吻合失败（17.6%），胆管重建失败（5.6%）为主。
结论：导致大鼠原位肝移植模型制作失败的原因较多，无肝期是影响成功与否的关键，及时地对失败原因进行分析总结并寻找合理的解决办法，有助于初学者熟练地掌握该技术。

Analysis of common causes of unsuccessful orthotopic liver transplantation in rats and their solution strategy

Objective: To analyse the common causes of unsuccessful orthotopic liver transplantation in rats, and provide an appropriate treatment strategy.
Methods: Over a period of 10 months, orthotopic liver transplantation model was performed by modified Kamada two-cuff technique in 150 rats. Completion of a set of 50 consecutive cases was regarded as an experimental stage, so the whole experimental course was partitioned into three stages: early, middle and late stage. The causes of transplantation failure in each stage were analyzed separately and summarized.
Results: In the early stage, the major causes leading to failure of rat orthotopic liver transplantation were pneumothorax (5.8%), intraoperative bleeding (10.6%), and exended anhepatic phase (50.4%), while those in the middle and late stage were failed anastomosis of suprahepatic inferior vena cava (21.0%), extended anhepatic phase (20.6%), failed anastomosis of portal vein and infrahepatic inferior vena cava (17.6%), and failed bile duct reconstruction (5.6%).
Conclusion: There are many causes of unsuccessful orthotopic liver transplantation in rats, among which, the anhepatic phase is the most critical factor affecting the results. Timely identification of the causes of unsuccessful transplantation and finding the appropriate solutions are helpful to the novice operators.