异位辅助肝移植治疗急性肝功能衰竭的实验研究

The Treatment of Ffulminant Hepatic Failure by Heterotopic Auxiliary Partial Liver Transplantation:a Experimental Study

目的：探讨异位辅助性部分肝移植治疗急性肝功能衰竭的可行性。方法：制作急性肝功能衰竭犬动物模型26只。分为两组：移植组20只,对照组6只。移植组切除脾脏后,于脾窝处移植同系异体60%部分肝脏,手术成功17只。观察两组实验动物的存活时间、血液生化、残肝磁共振(MRI)检查、残肝和移植肝的组织细胞形态改变。结果：对照组和移植组实验动物72h存活率分别为16．7%和82．7%。移植术后2周残肝细胞明显增生,肝功能恢复近正常,而辅助肝渐萎缩,术后5周辅助肝完全纤维化。结论：急性肝功能衰竭时,异位辅助性部分肝脏移植可为病肝提供暂时性功能支持,为残肝细胞再生、功能恢复提供机会,同时移植肝渐萎缩、纤维化。

Objective：To study the feasibility of heterotopic auxiliargy partial liver transplantation（HAPLT） in the treatment of fulminant hepatic failure（FHF）. Methods： FHF 26 rodial models were performed and then randomized into transplantation group 20 animals （T group） and control group （C group） 6 animals. 60% of partial liver grafts were implanted into the position of spleen in transplantation group with 17 successful operations. The surviual rate, biochemical test for liver function, MRI and pathological changes of the grafts and host livers were studied. Results： The surviual rate of T group in 72 hours was 82.7% compared with 16. 6% in C group. 2 weeks after the operation, the host liver 1 regenerated obviously and the liver function recovered while the graft shrank gradually. 5 weeks later, the graft became fibrosis completely. Conclusion：Depending on the temporary function support of the graft, the native residual liver could regenerate and restore its function while the graft tends to atrophy.