猪原位心脏移植的实验研究

①目的　通过建立猪原位心脏移植模型 ,为临床心脏移植提供依据。②方法　家猪 6 0头 ,分为供、受体两组 ,模拟临床心脏移植程序 ,进行供心切取、心脏保存和原位心脏移植。总结猪心脏血管解剖结构特点。测定移植前后血流动力学指标变化。③结果　共完成心脏移植 2 8例 ,因麻醉和受体心血管畸形原因各死亡 1例。猪心解剖结构与人类心脏相似。移植后猪平均动脉压与移植前比较差异有显著性 (t=2 .2 9,P <0 .0 5 ) ;移植后猪心排血指数与移植前比较差异有显著性 (t=2 .71,P <0 .0 1) ;其他指标比较差异无显著性 (t =1.36～ 1.70 ,P >0 .0 5 )。④结论　以猪作为动物模型模拟临床人心脏移植过程 ,用于基础和临床研究是可行的。

AN EXPERIMENTAL STUDY OF ORTHOTOPIC HEART TRANSPLANTATION IN PIGS

Objective To establish a porcine model of orthotopic heart transplantation to provide evidence for clinical heart transplantation. Methods Sixty pigs were divided into donor and receptor groups. The procedures of human heart transplantation, which included resection and preservation of donor hearts, and orthotopic transplantation, were simulated in the experiment. The characteristics of anatomical structures of swine heart were described and the hemodynamical indexes measured. Results Twenty-eightorthotopic heart transplantations were performed. Two pigs died, one of anesthesia asphyxia and the other of congenital heart abnormality. The anatomical structure of swine heart was found to be similar with human. The main pulmonary artery pressure(MPAP) after the transplantation decreased significantly(t=2.29,P<0.05),and so did cardiac index(CI)( t= 2.71,P<0.01). No significant difference existed in other indexes(t=1.36-1.70, P>0.05). Conclusion It is feasible to simulate the procedures of human operation with the porcine model of orthotopic heart transplantation for experimental and clinical studies.