受体肝两步切除法在犬活体肝移植模型建立中的应用

Application of receptors liver two steps removal method in experimental canine model of living liver transplantation

目的:观察犬肝脏解剖学特点,探索建立犬同种活体肝脏肝移植模型的新方法。方法:对10只杂交犬的肝脏进行活体解剖观察,根据肝脏解剖学特点,建立犬活体肝脏移植模型,其中受体手术首先切除门静脉左支供血的肝叶,将供肝植入后,再切除剩余的肝叶,应用受体肝脏两步切除方法,建立犬活体肝脏移植模型。结果:犬肝共分7叶,门静脉分左右支进入肝脏,单纯阻断门静脉左支,会引起门静脉压力一过性增高,不会引起胃肠道静脉淤血。受体组犬肝脏采取两步切除方法,免除了受体犬体外转流或门体分流的建立,可成功建立活体肝脏移植模型,且受体犬术中血流动力学稳定,无胃肠淤血发生。结论:犬是理想的部分肝移植动物模型,受体肝脏分两步切除,新肝植入期,可有效维持受体血循环稳定,避免了无肝期,免除了体外转流或门腔分流的操作。

Objective： To investigate the anatomical features of canine liver and study whether a modified living liver transplantation models can be established in canines.Methods： Ten liver specimens were observed in living canines.In living liver transplantation mode,for recipient group,the recipient dogs underwent two steps total hepatectomy： First the segments I,II,III,IV and V were resected.The segments VI and VII were maintained as well as the right portal vein and the retro-hepatic inferior vena cava order to keep the splanchnic and caval flux and to avoid the spleno-cavo-jugular by-pass.After the donor liver graft was then transplanted in an orthotopic position,the segments VI and VII were resected.Results： The liver has seven lobes.The portal vein terminated in the porta hepatic by bifurcating into right and left branches,Portal vein pressure reached peak level within 5 min and then descend to normal range after blockage of left or right branch of portal vein respectively.In living liver transplantation mode,for recipient group,the recipient dogs underwent two steps total hepatectomy,Dogs were appropriate animal model for a steady experimental partial liver transplantation.A porta systemic transfer was superseded in favor of an graft shunting and might effectively sustain the systematic circulation of recipient during anhepatic phase.Conclusion： Dogs are appropriate animal model for a steady experimental partial liver transplantation.Technique of two steps total hepatectomy in the recipient is feasible and may effectively sustain the systematic circulation of recipient.This model provides opportunity to develop techniques for partial liver transplantation in clinic.