猪到人异种心脏移植超急性排斥反应实验模型的建立：人血体外灌注猪冠状动脉系统

目的建立一种猪到人异种心脏移植超急性排斥反应实验模型。方法 8只广西巴马猪正中切口锯开胸骨进胸,肝素化,完整剪取猪心脏,用4℃生理盐水反复冲洗各心腔及心脏表面,用改良圣托马斯液经主动脉灌注,冲洗冠状动脉系统后,建立人血液体外灌注猪游离心脏冠状动脉系统,记录各模型心脏搏动的持续时间,1h后对灌注心脏进行免疫组织化学（测定IgG及IgM的沉积）及病理学分析。结果 8个人血液体外灌注猪心脏冠状动脉系统实验模型均成功建立,灌注心脏平均搏动时间为（9.25±1.90）min;心肌间质弥漫性出血、水肿,血管扩张,内皮细胞肿胀、坏死;心肌血管内皮细胞有IgG及IgM沉积。结论通过人血液体外灌注猪心脏冠状动脉系统建立的猪到人异种心脏移植实验模型能模拟超急性排斥反应,操作简单,容易复制。

Establishment of a model of hyperacute rejection in pig- to- human heart xenotransplantation: human blood perfusion of porcine coronary arterial system in vitro

Objective To establish a model of hyperacute rejection in pig-to-human heart xenotransplantation. Methods Eighit pigs were used. Thoracotomy was performed through median incision and then the pig heart was heparinized and completely clipped. Douching the surface ancl chambers of the hearts by cold saline and using ST. Thomas Ⅱ cardioplegia for aortal instillation were performed. A pig-tohuman heart xenotransplantation model was exploited based on an in vitro free heart blood perfusion system. After perfusion for 1 h, the survival time of the xenografts was recorded, and myocardium specimens were harvested for pathological analysis and detection of the deposit of IgG and IgM by immunohistochemistry. Results All 8 models of free heart blood perfusion system were successfully established in vitro. The mean survival time of perfusion hearts was （9.25 ＋ 1.90） min. Histopathologiea] examination showed diffuse hemorrhage, edema, necrosis of endothelial cells, and distension of blood vessels. The deposit of IgG and IgM was dramatically observed in the xeno~rafts. Conclusion A pig-to-human xenogeneic heart transplantation model can be easily established with in vitro free heart blood perfusion system. It is a simulated model with advantages of simple procedures and reproducibility.