大鼠原位肝移植模型的建立及术式改进

目的探讨用双袖套法建立大鼠原位肝移植模型的手术改进方法. 方法在Kamada等的袖套法吻合血管的基础上进行改进,供体改经腹主动脉进行肝脏冷灌注,肝上下腔静脉用缝合法吻合,门静脉和肝下下腔静脉用袖套法吻合,胆总管采用单管内支架胆管端端吻合下进行原位肝移植360例(次). 结果施行大鼠原位肝移植其供体手术时间(31.2±5.0)分钟,供肝修整时间(12.0±3.0)分钟,受体手术时间(45.0±5.5)分钟,无肝期(20.0±2.5)分钟,手术死亡31例,其中出血12例,肝下下腔静脉血栓8例,肝上下腔静脉回流不畅7例,袖套扭转或脱落4例.术后成活2天以上329例,成活率为91.4%.非干预组(非药物治疗组)1周存活率达86.5%. 结论改进的大鼠原位肝移植术操作简便,手术成功率高,可作为肝移植实验可靠、稳定的动物模型.

ANIMAL MODEL AND MODIFIED TECHNIQUE OF ORTHOTOPIC LIVER TRANSPLANTATION IN RATS

OBJECTIVE: To modify orthotopic liver transplantation method with two-cuff technique. METHODS: On the basis of cuff technique, the donor liver was perfused through the abdominal aorta with 20 ml cold perfusate. The anastomosis of the suprahepatic vena cave(SVC) was sutured end-to-end with 8/0 nylon line, and the continuity of infrahepatic vena cave(IVC) and portal vein(PV) were established by means of cuff method respectively. The bile duct anastomosis was performed by internal stent. RESULTS: Orthotopic liver transplantations were performed in 360 rats. The time for donor operation and liver preparation was (31.2 +/- 5.0) min and (12.0 +/- 3.0) min, and the recipient operative and anhepatic time was (45.0 +/- 5.5) min and (20.0 +/- 2.5) min, respectively. The two-day survival rate was 91.4%. In non-intervention group, one-week survival rate was 86.5%. CONCLUSION: The modified model is easily available and highly reproducible which provides a practical and stable experimental model for the study of liver transplantation.