胰-十二指肠移植肠内引流的新型大动物模型

目的 建立稳定的、符合生理的门静脉回流、空肠内引流术式猪全胰十二指肠移植模型。方法 20头四川本地杂种猪分为供、受体2组（n=10）。采用UW液低温灌注的方法，整块切取供体全胰十二指肠，保留腹主动脉段和门静脉。完整切除受体胰腺而建立Ⅰ型糖尿病模型。修整后的胰腺十二指肠移植物用腹主动脉膈下端与受体腹主动脉段端．侧吻合；门静脉与受体肠系膜上静脉端-侧吻合；十二指肠与受体空肠侧-侧吻合。结果 实验共完成猪全胰十二指肠移植手术10例。1例移植胰腺术后第六天血栓形成。平均生存14．6d。结论 此新型猪全胰十二指肠移植门静脉回流、空肠内引流术式大动物模型稳定、可靠。

Establishment of whole pancreaticoduodenal allotransplantation model with portal venous drainage and enteric drainage in pigs

OBJECTIVE: To establish an porcine model of whole pancreaticoduodenal transplantation with portal venous drainage and enteric drainage for ensuring physiologically normal function without hyperinsulinemia and reducing postoperative complications. METHODS: Twenty sichuan native outbreding white pigs weighing 25-30 kg were divided equally into two groups to serve as the donors and recipients. Cooling of the grafts was accomplished with in situ flush with 4 degrees C UW preservation solution via an aortic cannula. A whole pancreatoduodenal graft with the segment of abdominal aorta and the portal vein was harvested from the donor pigs. Type I diabetes model was established by complete removal of the recipient pancreas. The whole pancreatoduodenal graft was preserved and shaped in UW solution, and the subphrenic abdominal aorta of the recipient was joined with the donor abdominal aorta via a side-to-end anastomosis, and venous reflux was reconstructed between the donor portal vein and the recipient superior mesenteric vein. Side-to-side intestinal anastomosis was performed between the donor duodenum and the recipient jejunum. RESULTS: Ten pancreaticoduodenal transplantations (PVE+ED style) were done, and pancreatic graft thrombosis and embolism occurred only in 1 pig 6 days after transplantation. CONCLUSION: The model of whole pancreaticoduodenal transplantation with portal venous drainage and enteric drainage is stable and reliable.