大鼠“二袖套”法双重灌注全血供肝移植模型的建立

Establishment of rat model of "two-cuff method" liver transplantation with dual perfusion and blood supply of hepatic artery

目的:建立一个供肝灌注良好受体无肝期明显缩短及移植肝全血供稳定的肝移植动物模型。方法:“二袖套”法在Kamada吻合血管基础上改良,供肝分别经腹主动脉和门静脉双重全肝脏灌注;受体肝脏分步切除,肝上下腔静脉采用缝合法吻合,门静脉和肝下下腔静脉分别用袖套法吻合。移植肝脏动脉重建采用单纯血管套入式吻合或血管缝合的方法,胆总管采用单管内支架胆管端端吻合法。结果:共施行全血供大鼠原位肝脏移植76例(不包括预试验),手术成功率93.4%,1周存活率86.8%。结论:娴熟的显微外科技术、有效改良措施和注重手术细节是手术成功的保障,良好的灌注、受体无肝期的缩短及重建移植肝脏动脉血供能有效提高动物模型的稳定性。

Objective： To establish a reliable rat model of orthotopic liver transplantation with well perfusion, shortened anhepatic phase and hepatic artery reconstruction in transplanted liver. Methods： The model was established with modified cuff technique. The donor liver was cold perfused through abdominal aorta and portal vein respectively, the liver of recipient was step-excised, the suprahepatic vena cave（VC）was sutured end -to -end with 8-0 nylon line, and the continuity of infrahepatic VC and portal vein（PV）were established by means of cuff method respectively. The blood supply of hepatic artery of the recipient rat was reconstructed by a modified arterial ＂sleeve＂ anastomosis and the anastomosis of the common bile duct was performed with an internal stent. Results： There were 76 liver transplantations performed with hepatic artery reconstruction. The 24h and one week survival rate after operation was 93.4% and 86.8% respectively. Conchusions： It is important for successful operation with sophisticated microsurgical technique, effectively modified measure and attention for operation details. Well perfusion, shortened anhepatic phase of recipient and hepatic artery reconstruction in transplanted liver can increase the stability of animal model.