保留门静脉-腔静脉血流的肝移植实验研究

Experimental studies on the liver transplantation with the preservation of portal and venecave blood flow

为探讨犬肝移植的新术式，以及不采取静脉转流的可行性，施行了犬保留门静脉－腔静脉（门－腔）血流的背驮式肝移植术。受体在切除自体肝之前先将肠系膜下静脉与右肾平面以下的下腔静脉行侧侧吻合，建立门－腔血流通路，然后再行原位肝移植术；测定受体切肝及植肝等５个时限的血流动力学参数。结果５只犬有４只存活，在下腔静脉及门静脉吻合后５～１０分钟即有胆汁分泌。血流动力学的有关指标表明，造成心血管系统不平衡、肾瘀血、胃肠瘀血等危险因素被解除。认为本术式更符合人的内环境及生理，避免了静脉转流术的各种弊端，为无转流泵的中心施行肝移植找到了新的途径。

In order to investigate a new procedure for dog liver transplantation and the reliability of not using vein bypass, piggyback liver transplantation was performed with the preservation of portal and venecave blood flow. The experimental animals (hybrid dogs) were divided into three groups. The donor operation is similar to the standard liver procurement. The recipient was preserved the IVC and established the bypass bridge between portal vein and IVC. The hemodynamical parameters were monitored during operation. The results showed that this technique could substitute for the traditional veins bypass. 