破坏狗肾淋巴循环对移植肾影响的实验研究

目的：探讨自体肾移植后淋巴因素对移植肾的影响，为肾移植术是否需要吻合淋巴管提供参考。方法：实验动物为８只成年家犬，开腹，游离并切断左侧肾蒂，置于左髂窝，将肾动脉与左髂内动脉吻合，肾静脉与左髂总静脉吻合，但不吻合淋巴管，右肾作为对照，分别在术后第８、１２、２１天处死动物，用肉眼，光镜和透射电镜观察移植肾的变化。结果：肉眼观，左右肾的大小，颜色，质地无差别，但移植肾与周围组织广泛粘连；光镜：健侧肾皮质肾小管上皮细胞有水样变性，髓质内偶见少量的蛋白和细胞管型。患侧肾除见到与健侧类似的变化外，皮质内偶见脂肪变性，少数肾小球萎缩，部分肾小球代偿性肥大和集合管间质轻度纤维化；电镜：两侧肾小球无明显异常，实验侧近曲小管上皮细胞肿胀，微绒毛排列紊乱，胞浆内空泡增多，线粒体模糊，溶酶体增多，远曲小管和集合管部分上皮细胞坏死。结论：肾移植时可暂不考虑吻合淋巴管

Experimental study on transplanted kidney with destroyed lymphatic circulation

Objective:To explore lymphatic factor affected for kidney transplantation and to provide reference for kidney transplantation.Methods:Eight left kidneys of dogs were dislocated and anastomosed with left internal iliac arteries and left common iliac veins respectively,but the lymphatic anastomosis was not performed.The animals were killed on days 8,12 and 21 respectively.The bilateral kindneys were removed out and observed by naked eye or under light and transmission electron microscopes.Results:There was no obvious change in size,color and hardness between left and right kindneys but adhesion with adjacent tissue in transplanted kidneys.Under light microscope,there were hydropic degeneration in epithelial cells of proximal tubule in right renal cortex and a little protein and cellular casts in medulla.The changes in transplanted kidney were the same as those in healthy kidney,with the exceptions of fatty degeneration,atrophy and compensatory hyperterophy of glomerulus,and mild interstitial fibrosis of collecting tube.Under TEM,epithelial turgescence of proximal tubule,irregular arrangement of microvilli,increase of vacuole and lysosme in cytoplasm and epithelial necroses of distal convoluted tubule and collecting tube could be seen.Conclusions:This lymphatic anastomosis could be disregarded temporarily.