脾窝异位辅助性肝移植治疗大鼠急性肝衰的早期实验研究

Early empirical study for the treatment of rat acute hepatic failure by auxiliary heterotopic liver transplantation in spleen fossa

目的建立稳定的急性肝功能衰竭和脾窝异位辅助性肝移植大鼠模型,研究移植肝对大鼠急性肝功能衰竭的早期支持作用,探讨原肝再生与移植肝萎缩之间的关系。方法随机抽取近交SD大鼠将其分为:A组(n=40),切除脾脏和左侧肾脏,将小体积移植肝(30%)植入该受体脾窝;B组(n=20)为对照组,切除85%肝脏+脾脏+左侧肾脏。观察两组术后存活率、血生化变化、两肝重量及病理变化。结果A组术后1d、3d、7d、14d存活率明显高于同期B组(P<0.05);A组术后肝功能指标随时间进行性下降,术后14d基本接近正常,且大大低于同期B组水平,与同期B组比较有统计学意义(P<0.05);A组大鼠原肝随时间进行性增生,移植肝在早期无明显改变,14d左右开始萎缩。结论脾窝辅助性肝移植治疗大鼠急性肝衰方法科学、合理、可行;移植肝对大鼠急性肝衰有明显的支持作用;原肝术后呈进行性增生改变,移植肝在早期无明显变化,随着大鼠原肝再生、肝功能逐步恢复移植肝开始出现萎缩性改变。

Objective To establish a stable rat model of acute hepatic failure and a rat model of heterotopic auxiliary liver transplantation in spleen fossa with splenectomy.To observate the survival rate.To study the pristine effects of graft liver in supporting acute hepatic failure.To investigate the relationship between the regeneration of host liver and the atrophy of graft liver.Methods Healthy SD rats undergoing 85% partial hepatectomy,were divided randomly into two groups as follows： group A（n=40） after a left nephrectomy and lienectomy,the graft liver which was reduced to about 30% of the original size,was inplanted into the spleen fossa of the recipient＇s abdomen. Group B（n=20） control group with a left nephrectomy and lienectomy.Observating the survival rate of groupA and B;Detecting the blood-serum both of them.Executed the suvival rat of group Aand group B,take out of graft liver and host liver for weighing and hematoxylin and eosin staining.Results The homochronous survival rate of group A was highter than that of group B obviously （P〈0.05）.The parameter of ALT, AST, GGT,TB,PT of group A degraded obviously and approach to the nomal value gradually with time variancing after operation and were more less than group B（P〈0.05）. The weight of host liver increased gradually with time variancing and show hyperplasia under microscope after operation.while it＇s no significant change 7d postoperative and lighten slightly 14d postoperative and show hyperpiasia in extent.Conclusion Auxiliary heterotopie liver transplantion in spleen fossa is feasable and scientific;The graft liver play an exact support role for the rat on passing the acute hepatic failure time;The host liver is weighting and hyperplasing gradually with time varianeing after operation, the graft liver show no significant change under macroscopic and microscope observation at prophase,but it show slight degeneration with the recovering of host liver.