大鼠肝移植小移植物模型的研究

目的 建立大鼠肝移植小移植物模型，探讨移植物体积对受体生存的影响。方法 48只雄性SD大鼠随机分为4组：70％肝切除组(A组)、全肝移植组(B组)、中等移植物组(C组)、小移植物组(D组)。观察各组大鼠生存率。于术后不同时间点，采取外周静脉血检测肝功能；行肝组织常规组织学及透射电镜检测。结果 D组第3天生存率为56％，显著低于A、B、C组(P＜0．01)；各时间点D组各生化指标均显著高于其他3组(P＜0．01)；A、C和D组肝脏组织学以肝细胞再生的表现为主，B组以淋巴细胞浸润为主。D组术后第3天光镜下和透射电镜检查可见分裂肝细胞；第21天移植肝体积已达正常水平。结论 大鼠肝移植小移植物模型供肝量应超过全肝重量的45％。影响小移植物成活的主要因素是缺血—再灌注损伤和手术技术。

Establishment of small graft model in rat orthotopic liver transplantation

Objective To establish a small graft model in rat orthotopic liver transplantation and study the effect of graft volume on the survival of recipient rats.Methods Forty-eight SD rats were randomly divided to 4 groups.Group A: 70% hepatectomy; group B: orthotopic liver transplantation; group C: the graft volume/liver standard volume (GV/SV) ratio was about 60%; group D: GV/SV was about 45%.The survival rate curve was made.Main indexes of liver function and morphological observation were performed in different time points postoperatively.Results The survival rate on the postoperative 3rd day in the group D was 56%,significantly lower than that in groups A,B and C (P<0.01).The main indexes of liver function in group D were much higher than those in the other three groups (P<0.01).Infiltration of large number of lymphocytes into the portal areas was found in group B,and the regeneration of hepatocytes was observed in groups A,C and D.The proliferating hepatocytes with double nucleus were found under electron microscopy in the graft tissue in group D on the 3rd day postoperatively.The graft liver has grown to normal liver volume on the 21st day.Conclusion The GV/SV rate should be more than 45% in the small graft model.The main reasons for the survival rate of small graft is ischemic-reperfusion injury and operative techniques.