门脉建立侧袖式大鼠肝／小肠整块联合移植模型

En bloc combined liver and small- bowel transplantation in rats： construction of a cuff in portal vein

目的建立大鼠肝、小肠整块联合移植模型。方法用Wistar大鼠行同种异体肝、小肠整块联合移植。肝肠联合移植整块切取移植物时，保留门静脉完整性，利用供体腹段下腔静脉在门静脉侧壁上建立一侧袖，并安置套管。然后按kamada二套管法行原位肝移植，动脉重建通过供体腹主动脉与受体腹主动脉行端侧吻合以建立肠系膜上动脉及肝固有动脉血供。回肠末端在右下腹造瘘。结果手术成功率为86％，动物平均存活时间大于30d。病理组织学检查发现移植肝和小肠结构正常。结论用门脉建立袖套式血管吻合技术施行大鼠肝、小肠整块联合移植模型是可行的。

Objective To establish a model of en bloc combined liver/small bowel transplantation in the rat. Methods Homoplastie transplantation of en bloc combined liver and small-bowel in Wistar rats was performed. As for the donor operation, the portal vein and superior mesenteric artery were flushed with 4℃ cold Ringer＇s solution. The small intestinal lumen was flushed with 4℃ cold Neomycin solution. The donor small bowel and liver were harvested, preserved and transplanted as a whole. The donor inferior vena cava in abdomen was cut to construct a muff in the lateral wall of portal vein and cuff was placed. For the recipient operation, the orthotopic liver transplantation was completed at first by using Kamada＇s two cuff technique, and then the donor abdominal aorta was anastomosed end to side to the receptor abdominal aorta artery to set up superior mesenteric artery and proper hepatic artery blood flow under a microscope. The lower ileum was exteriorized as stoma in right lower abdomen. Results The successful rate of operation was 86 %. The mean survival time of the grafted rats was over 30 d. The transplanted liver and small bowel were normal in histology. Conclusion It is feasible to establish a model of en bloc combined liver and small bowel transplantation by constructing a cuff in portal vein.