改良三套管法建立小鼠左肺原位移植模型

Establishment of Orthotopic Left Lung Transplantation Model in Mice with Modified Three-cuff Technique

目的探讨采用改良三套管法建立稳定的小鼠左肺原位移植模型。方法取近交系雄性C57BL/6小鼠50只随机分为供体、受体,二者体重相近,采用改良三套管法进行左肺原位移植,术后4周进行显微胸部CT、动脉血气分析及病理学检测。结果该实验行肺移植25例,除1例因肺静脉撕裂致手术失败外,余24例均成功进行移植手术,手术成功率为96%(24/25)。术后1例受体鼠因呼吸道分泌物过多致气道阻塞而死亡,死亡率为4.2%(1/24)。供肺灌注到摘取时间为(6.2±1.8)min,供肺体外套管所需时间(15.0±2.4)min,供、受者完成吻合所需时间为(31.6±5.2)min,冷缺血时间为(32.5±3.5)min,热缺血时间为(31.3±8.9)min,整个手术过程耗时(88.0±12.0)min。术后4周,显微CT检查结果显示,受体鼠移植肺野清晰,膨胀良好;血液气体分析结果显示,阻断右肺门前、后的氧气分压比较,差异无统计学意义(P>0.05);移植肺组织的病理学检查显示,与正常右肺相比,移植左肺结构正常,肺泡通气良好。结论改良后的三套管法是一种简单有效、经济实用的吻合方法,可以成功地建立稳定的小鼠左肺原位移植模型。

Objective To investigate the establishment of stable orthotopic left lung transplantation model in mice with modified three-cuff technique.Methods Fifty male C57BL/6mice randomly served as donors and recipients.Each couple had the similar weight.Modified three-cuff technique was used to establish the orthotopic lung transplantation model in mice.The micro chest CT,artery blood analysis and histological examination of the graft were conducted four weeks after transplantation.Results Twenty-five transplantations were completed with an overall success rate of 96%（24/25）.One recipient developed pulmonary vein injury,resulting in surgical failure.One animal died from airway obstruction caused by excessive respiratory secretion after surgery,and the mortality rate was 4.2%.Donor lung perfusion-picking time was（6.2±1.8）min,donor lung cuff preparation time was（15.0±2.4）min,cold ischemia time was（32.5±3.5）min,warm ischemia time was（31.3±8.9）min, donor lung back-up time was（31.6±5.2）min,and total procedure time was（88.0±12.0）min.Micro CT showed clear graft lung field four weeks after transplantation,and the graft expanded satisfactorily.There was no significant difference in the blood gas analysis before and after right pulmonary hilum occlusion（P〉0.05）.Histological examination revealed that the graft appeared very similar to the right lung four weeks after surgery,and the pulmonary alveoli were aerated well.Conclusion Modified three-cuff technique is a simple,effective,economic and practical anastomosis method.It will be used to establish the stable lung transplantation model in mice.