小鼠原位小肠移植模型的建立(英文)

Mouse model of orthotopic small bowel transplantation

目的:探索原位小肠移植的手术技术,为研究移植小肠功能及排斥反应提供良好的动物模型。方法:采用小肠供体的门静脉与受体下腔静脉端侧吻合,供体带主动脉片的肠系膜上动脉与受体腹主动脉端侧吻合,受体相应长度肠管切除,供体近、远端肠管与受体相应肠管切除后近、远端以端端吻合的方式建立原位小肠移植模型。术后禁食4 d,不禁饮,每天分2次经皮下分别给予5%葡萄糖生理盐水2 mL,术后不使用抗生素和免疫抑制剂。小鼠存活超过5 d认为手术成功。结果:行原位小肠移植30次,术后5 d存活率达60%(18/30)。手术失败的12例小鼠主要死亡原因为动脉吻合口部位狭窄及吻合口处血栓形成5例,吻合口出血导致出血性休克2例,术后肠瘘导致腹腔内感染5例。供体手术时间(40±4.5)min,热缺血时间约0.5min,供体肠段肠系膜上动脉组织片修整时间约为3 min,供体冷保存时间为(30±7.5)min,受体手术时间(95±8.0)min,其中腹主动脉及下腔静脉阻断时间为(38±3.5)min,静脉吻合时间(10±2.0)min,动脉吻合时间(15±3.0)min,成活小鼠受体手术平均出血量约0.2 mL。结论:良好的供体肠段的获取、高质量的血管吻合和肠道吻合及供、受体补液是提高小鼠小肠移植手术成功率的关键。

Objective To investigate the surgical procedures of orthotopic small bowel transplantation（SBT） model in mice to study the function and rejection of SBT.Methods We established a mouse SBT allograft model as follows： the donor portal vein was anastomosed end by side with the recipient inferior vena cava;the donor superior mesenteric artery with aorta patch was anastomosed end by side with recipient abdominal aorta.After an appropriate length of the recipient＇s small bowel was removed,the donor＇s small bowel and the recipient＇s small bowel were end-to-end anastomosed discontinuously.The mice were fasted for 4 d after the operation,free access to water and subcutaneously injection of 2 mL of 5% glucose saline twice daily.Operation success was regarded as survival for more than 5 d.There is no antibiotic and immunosuppressor.Results A total of 30 transplantations were done,the 5 d survival rate was 60%（18/30）,and 12 died within 5 d.Among the dead recipients,5 died of arterial anastomotic stenosis and anastomotic thrombosis,2 of hemorrhagic shock caused by anastomotic bleeding,and the other 5 of intra-abdominal infection caused by postoperative intestinal fistula.The donors＇ operative time was（40±4.5） min,warm ischemia time was about 0.5 min,donor preparation time was about 3 min,and cold preservation time was（30±7.5） min.The recipients＇ operative time was（95±8.0） min,among which,the abdominal aorta and inferior vena cava clamping time was（38±3.5） min,the venous anastomotic time was（10±2.0） min and the arterial anastomotic time was（15±3.0） min.The mean intra-operative blood loss of the surviving recipient mice was about 0.2 mL.Conclusion High quality vascular anastomosis,and rehydration of donors and recipients are crucial factors for improving the success rate of SBT.