建立肝肠联合移植大鼠模型及移植肝对小肠的免疫保护作用

目的：建立新型肝肠联合移植大鼠模型，并研究移植肝是否对移植肠具有免疫保护作用。方法：肝肠联合移植切取移植物时，保留门静脉完整性，利用供体胸段下腔静脉在门静脉侧壁上建立～袖套，并安置套管。受体手术时，将此袖套与受体门静脉残端套管法吻合。动脉重建通过供体肠系膜上动脉与受体右肾动脉端端吻合。免疫保护作用通过术后病理学检查评估。结果：用此法建立肝肠联合移植大鼠模型手术无肝期显著缩短，与Kamada双套管法肝移植无肝期相同，血流动力学影响小，手术成功率高。术后7、14天异基因小肠移植组出现重度排斥反应，而肝肠联合移植组仅表现为中度排斥。结论：用该方法建立一期大鼠肝肠联合移植模型方便可行，且成功率高。肝肠联合移植时移植肝对移植小肠具有免疫保护作用。

The Preparation of Combined Liver/Small Bowel Transplantation Model in Rats and the Study on Protective Role of Liver from Small Bowel

Objective: To prepare a new combined liver/small bowel transplant at ion model in rats and to investigate the protective role of the transplanted liv er from transplanted small bowel. Methods:In the course of combined liver and sm all bowel transplantation,the donor liver and small bowel were dissociated , rem oved and transplanted as a whole. After the graft was perfused ,donor inferior v ena cava in chest was cut to construct a muff in the lateral wall of portal vein and cuff was placed. In recipient operation, the portal veins of both donor and recipient were connected by using cuff technique and rearterialization was comp leted by anastomosing the superior mesenteric artery of graft with right kidney artery of the recipient.The acute rejection was monitored through the examinatio n of pathology. Results: The anhepatic duration of recipient was the same as tha t in Kamada's method of liver transplantation with a relatively fewer hemodynami c changes and with a higher survival rate .The small bowel in the isolated small bowel transplantation showed severe rejection,but displayed moderate acute reje ction in combined liver and small bowel transplantation at 7th and 14th days aft er operation. Conclusion: This technique of prepareing simultaneous liver and sm all bowel transplantation model in rats is feasible and the simultaneously trans planted liver can protect small bowel from rejection. [