非协调性异种肝移植后再灌注障碍及超微结构变化的观察

The ultrastructural changes and reperfusion disturbance of the xenograft following discordant liver xenotransplantation

目的 :探讨非协调性异种肝移植供肝再灌注障碍与超急性排斥反应的可能关系。方法 :应用改良缝合法建立豚鼠至大鼠的肝移植动物模型 ,观察供肝再灌注 6 0分钟内门脉灌注和肝脏组织超微结构的变化。结果 :移植后 6 0分钟供肝门脉灌注明显减少 ;肝细胞的线粒体明显肿胀 ,线粒体嵴破坏、结构紊乱 ,内质网扩张、脱粒 ,肝细胞狄氏间隙消失 ,肝血窦内可见到血小板和粒细胞粘附、聚集和血栓形成 ,部分内皮细胞消失。受体心肌细胞肿胀 ,肌原纤维排列紊乱、疏松化和断裂 ,线粒体呈多形性 ,大小不等。结论 :豚鼠至大鼠非协调性异种肝移植 6 0分钟时有超急性排斥反应的发生 ,从而导致供肝的灌注障碍 ,同时心肌的受损可以进一步加重供肝的微循环障碍。

Objective: To determine the possible relationship between the ultrastructural changes and reperfusion disturbance of the xenograft following discordant liver xenotransplantation.Methods: In the Guinea pig to rat liver transplantation model, the portal blood flow(PBF) and the ultrastructural changes of xenografts at 0,30 and 60 minutes were observed after transplantationResults:The reperfusion state of the xenograft was poor after transplantation. Liver ultrastructural findings showed swollen mitochondrias, loss of space of Disse, enlarged endoplasmic reticulum and leukocytes infiltration.Conclusion: Hyperacute rejection occurred after xenogeneic liver transplatation ,which leads to the hyporeperfusion of the xenografts.