猪全胰十二指肠移植空肠引流及门静脉回流模型的建立

目的　建立猪的全胰十二指肠移植空肠内引流 ,门静脉回流模型。方法　 40头杂种猪分为供体组和受体组 ,对供体组 ( n=2 0 )进行 U W液低温灌注 ,切取全胰十二指肠以及部分腹主动脉和门静脉。修剪移植胰腺和十二指肠 ,U W液保存移植物的肠系膜上动脉开口和腹腔动脉开口分别与供体的髂内外动脉端 -端吻合呈“Y”形。切除受体组胰腺建成 型糖尿病模型 ,移植物的门静脉与受体的肠系膜上静脉吻合 ,移植物“Y”形的髂总动脉与受体腹主动脉端侧吻合。十二指肠与空肠侧侧吻合。结果　本实验完成全胰十二指肠移植 2 0例 ,胰腺移植手术中因麻醉过深呼吸抑制死亡 1例 ,2例手术后移植胰腺形成血栓、梗死。 17例手术后 2 4h外周血检测血糖正常 ,移植胰腺存活时间平均 18.6± 2 .6d。结论　成功地建立了猪全胰十二指肠移植空肠引流及门静脉回流的模型

Establishment of Whole Pancreaticoduodenal Allotransplantation Model with Jejunum Drainage and Portal Venous Drainage in Pigs

OBJECTIVE: To establish a pig model of pancreaticoduodenal transplantation with jejunum drainage and portal venous drainage. METHODS: Forty pigs were randomly divided into the donor group and recipient group. University of Wisconsin (UW) solution was used for both in situ flush and storage of all organs under cold storage conditions. Whole pancreaticoduodenal graft was harvested with segments of abdominal aorta and portal vein and shaped under cold UW solution. Then, the end-to-end anastomosis was performed with the donor iliac artery bifurcation Y graft to the recipient superior mesenteric arteries and celiac artery. Furthermore, type I diabetes model was made by removal of the recipient pancreas The venous anastomosis was reconstructed between the donor portal vein and the recipient superior mesenteric vein. Meanwhile, the end-to-side anastomosis was performed with the donor common iliac artery bifurcation Y graft to the recipient abdomial aorta, and the side-to-side intestinal anastomosis between the donor duodenum and the recipient jejunum was performed. RESULTS: Twenty piges were subjected to pancreaticoduodenal transplantation, in which 1 died from respiratory depression because of anesthesia, and 2 had thrombus and infarction in the pancreatic graft after transplantation. 17 cases showed normal blood sugar in peripheral circulation 24 hours after operation, the mean survival of the graft was 18.6 +/- 2.6 days. CONCLUSION: The technique of duodenal transplantation with jejunum drainage and portal venous drainage may pave the way for the further development of pancreas transplantation in clinical practice. It can be utilized in basic research of pancreas transplantation.