门静脉回流技术在胰肾联合移植动物实验中的应用

Use of portal venous drainage in simultaneous pancreas-kidney transplantation in experimental animals.

目的研究门静脉回流技术在胰肾联合移植动物实验中的应用。方法 24只杂交长白猪随机分为体循环回流组(SVD)和门静脉回流组(PVD),每组内随机分为供、受体,经供体猪腹主动脉原位灌注,大块联合切取供体胰、节段十二指肠、左肾、脾脏。修剪移植肾脏、胰腺和十二指肠,左肾静脉与肠系膜上静脉吻合后．PVD组采用移植物门静脉与受体肠系膜上静脉吻合,SVD组采用移植物门静脉与下腔静脉吻合。各组腹主动脉与受体腹主动脉吻合,十二指肠内置人T型管、输尿管内置人脑室引流管自腹壁引出待Ⅱ期手术吻合。结果 SVD组和PVD组手术均很成功,供肾、胰植入受体后立即恢复良好的血液循环,并且迅速恢复功能,平均存活期分别为12d和14d。结论门静脉回流技术是可行的。

Objective To validate portal venous drainage in simultaneous pancreas-Kidney transplantation in experimental animals. Methods 24 pigs were randomly assigned to two groups： the systemic venous drainage group（SVD） and the portal venous drainage group（PVD）, and each group was equally and randomly subdivided into donors and recipients. The donor＇s whole pancreas, segmental duodenum, left kidney and spleen were symphysially resected after perfusion through the abdominal aorta in situ. Then the grafts were sheared, the left kidney vein and the inferior mesemeric vein of the grafts were end-to-end anastomosed, and the portal vein of the graft and the inferior mesenteric vein of the recipient was anastomosed. An end to-side anastomosis between the abdominal aorta of the allograft and that of the recipient was performed. A T-tube was inserted in the duodenum, and a ventricular drainage tube in the ureter for external draiange, Results The operation was successful. The kidney and pancreas allografts recovered immediately after operation. The mean survival time was 12 days. Conclusions The technique of portal venous and exocrine external drainage in simultaneous pancreas-kidney transplantation is feasible.