大鼠右肺原位移植模型的建立

A model of orthotopic right lung transplantation in rats

目的探讨建立大鼠右肺原位移植模型的手术技术，以及该模型应用于缺血再灌注损伤研究的可行性。方法选用纯种雄性SD大鼠（体重250-270g）作为肺移植模型的供、受者。供、受者的手术均在手术放大镜下进行，由同一操作者连续完成大鼠右肺原位移植模型12例。供者全身麻醉后行机械通气，正中切开胸腹暴露心脏和双肺，下腔静脉注射肝素，切开右室流出道和左心耳放血后将灌注管插入肺动脉内行肺灌注，灌注完成后切取并保存供肺。右肺移植时，受者全身麻醉和辅助呼气方法同供者。右后外侧第4肋间切口入胸，游离并从远端切断肺血管和支气管，将供肺植入受者胸腔后，分别吻合支气管及肺动、静脉。观察受者术中及术后的情况。结果供肺平均冷缺血时间为（131．25±20．24）min；平均移植时间为（91．25±15．97）min。开放循环后24h，共有8只受者存活，手术成功率为66．7％。有6只受者存活时间超过4周。结论大鼠有肺原位移植模型难度较大，但它是一种新型的适用于肺移植缺血再灌注损伤研究的动物模型。

Objective To report the preliminary experience with the techniques of orthotopic right lung transplantation in rats. and to evaluate an application of the model in the study on ischemiarepeHusion injury after experimental lung transplantation. Methods Pure breed SD rats （weighing 250-270g） were chosen. Under an operation microscope （10） for both donor and recipient procedures, 12 consecutive orthotopic right lung transplantations in rats were performed. Under the general anes thesia and mechanical ventilation, middle line laparothoracotomy was used to expose the heart and bi lateral lungs. Heparin was given through the inferior vena cava. After opening the right ventricular outflow tract and exsanguinating through the left auricle, a perfusion catheter was placed in the pul monary artery. Following lung perfusion, the donor lung was retrieved, and properly preserved. The techniques of general anesthesia and mechanical ventilation for the recipient were the same as the do nor. Right posterior thoracotomy through the fourth intercostal space was performed. Pulmonary vessels and bronchus were isolated, clamped and excised as far from the clamps as possible. Donor lung was implanted, all bronchial and vessel end-to-end anastomoses were hand-sewn with 9-0 single strand running suture. The recipients＂ intraoperative and postoperative conditions were recorded. Results The mean cold ischemic time of the graft was （131.25 ± 20.24） min; mean time of lung transplanta tion was （91.25 ±15.97） min. A total of 8 recipients survived for the entire 24 h observation period. Success rate of right lung transplantation was 66.6 %. Furthermore, 6 recipients survived for more than 4 weeks. Conclusion Rat right lung transplant model is a new option for ischemia reperfusion injury study after lung transplantation.