大鼠肝、肾联合移植模型的建立

Establishment of simultaneous liver-kidney transplantation model

目的探讨大鼠肝、肾联合移植模型的建立方法及并发症的预防.方法以SD大鼠为供、受者,用0～4℃乳酸钠林格注射液经腹主动脉对供肝和供肾进行原位灌洗,整块切取供鼠的肝、肠、胰、脾及右肾,浸泡在保存液中修整.移植时血管重建全部采用袖套式吻合,应用支架行胆总管吻合,输尿管采取所附带的膀胱瓣与受者的膀胱吻合.结果共行大鼠肝、肾联合移植110次,其中预实验50次,受鼠死亡18只;正式实验60次,受鼠死亡5只,余下的大鼠均存活30 d以上,存活率为91.7%(55/60).结论袖套法建立大鼠肝、肾联合移植模型降低了手术难度,具有血管吻合时间短、血流通畅、无肝期短等优点,术前准备、术中操作及术后处理等各环节对于并发症的预防具有重要作用.

Objective To explore a better method for establishing rat model of simultaneous liver-kidney transplantation and the prevention of complications after transplantation. Methods In the donor operation, the liver and the right kidney were flushed with 0.4℃ sodium lactate Ringer＇ s injection through aorta, and en bloc resection of organs of right kidney, liver, pancreas, intestines, and spleen were done. Preparation was performed in the preservation solution. During the recipient operation, all the blood vessels were reconstructed with cuff methods. The bile duct was anastomosed using a simple inside bracket. Operation of connecting ureter attached part of bladder with the bladder was conducted. Results One hundred and ten simultaneous liver-kidney transplantations including 50 preliminary experiments were carried out. Eighteen recipient rats died in the preliminary experiments. Five recipient rats died in the formal experiments and all the remaining had survived for more than 30 days. The successful rate of formal transplantations was 91.7 %. Conclusion This kind of rat model of simultaneous liver-kidney transplantation is simple. The time for blood vessel anastomosis and anhepatic stage was reduced. Complications such as stenosis were avoided. Preparation before operation, manipulation after operation and management after operation can affect the establishment of the model.