大鼠40%小体积肝移植肝动脉重建的意义

Significance of Hepatic Arterial Reconstruction on Model of Small-for-Size Orthotopic Liver Transplantation in Rats

目的探讨肝动脉重建在大鼠小体积肝移植中的意义。方法采用改良二袖套法建立大鼠40%小体积肝移植模型,实验分重建动脉组和未重建动脉组,观察1周生存率,并于术后1、2、4及7 d检测肝功能、观察移植肝组织学变化以及免疫组化法检测肝细胞增殖细胞核抗原(PCNA)的表达。结果重建动脉组1周生存率为65.0%(13/20),未重建动脉组1周生存率为50.0%(10/20),2组比较差异无统计学意义(P>0.05)。2组ALT和TB于术后第1天即开始明显升高,第2天达高峰,以后逐渐降低;重建动脉组TB于第2、7天低于未重建动脉组,ALT于第2、4天低于未重建动脉组,差异均有统计学意义(P<0.05)。重建动脉组术后中央静脉及肝窦扩张程度较未重建动脉组相对较轻,可见较多二倍体和多倍体肝细胞;2组大鼠移植肝的肝细胞中PCNA表达均于术后第2天达高峰,重建动脉组术后第1天的PCNA表达阳性率高于未重建动脉组(P<0.01),而术后第7天则低于未重建动脉组,差异有统计学意义(P<0.05)。结论肝动脉重建可明显改善大鼠小体积移植肝的功能,促进移植肝的再生,有效地保护移植肝的组织学结构,重建动脉组术后早期肝细胞增殖较未重建动脉组活跃。

Objective To investigate the significance of hepatic arterial reconstruction on the model of 40% small-for-size orthotopic liver transplantation in rats. Methods Modified two-cuff technique was applied to establish a rat model of 40% orthotopic liver transplantation. A total of 240 Sprague Dawley （SD） rats were randomly divided into 2 groups： reconstructive artery group and non-reconstructive artery group. One week survival rate was observed. Main indexes of liver function, histology and the expression of proliferative cell nuclear antigen （PCNA） of liver graft （by immunohistochemical method） were detected on day 1, 2, 4 and 7 after transplantation, respectively. Results One week survival rates of reconstructive artery group and non-reconstructive artery group were 65.0% （13/20） and 50.0% （10/20） respectively （P〉0.05）. Alanine aminotransferase （ALT） and total bilirubin （TB） began to elevate from day 1 and peaked on day 2 after surgery in two groups. ALT in non-reconstructive artery group on day 2 and 4 were significantly higher than that in reconstructive artery group （P〈0.05）. TB in nonreconstructive artery group on day 2 and 7 were significantly higher than that in reconstructive artery group （P〈0.05）. Histological findings indicated that more diploid and polyploid hepatocytes and more gently dilation of central veins and hepatic sinusoids could be seen postoperatively in reconstructive artery group. The expression of PCNA of liver graft peaked on day 2 after surgery. The expression of PCNA of reconstructive artery group was higher on day 1 （P〈0.01） and lower on day 7 than that of non-reconstructive artery group after operation （P〈0. 05）. Conclusions Arterial reconstruction can improve liver function of liver grafts after small-for-size orthotopic liver transplantation, alleviate the histological changes and promote the regeneration of liver grafts quickly.