大鼠肾移植模型手术改良技巧探讨

Modified technique of renal transplantation model in rats

目的探讨大鼠肾移植模型手术的改良方法。方法供体Sprague-Dawley(SD)大鼠21只,受体Wistar大鼠42只。采用双侧供肾。受体左肾切除后借助自制导管,行受体肾动脉与供体肾动脉、受体肾静脉与供体下腔静脉端端吻合,供体输尿管带膀胱瓣与受体膀胱吻合,最后切除右肾,腹腔内注入头孢米诺10 mg,关腹。记录手术时间,动、静脉吻合时间,冷、热缺血时间等手术数据;术后大鼠存活3 d认为模型建立成功,计算建模成功率,分析死亡原因。结果供体手术时间为(32.7±5.6)min,供肾修整时间为(4.2±1.1)min。受体手术时间为(42.3±4.9)min,其中动脉吻合时间为(10.1±3.2)min,静脉吻合时间为(13.9±2.5)min,尿路重建时间为(6.3±1.4)min。热缺血时间为(5.4±1.8)s,冷缺血时间为(56.2±7.3)min。42只受体大鼠中,建模成功40只,成功率为95%。另2只受体大鼠死亡,其中1只死于血管吻合口出血,1只死于尿瘘引致的腹膜炎。结论采用改良的血管端端吻合法建立大鼠肾移植模型具有操作简单、手术时间短、成功率高的特点。

Objective To investigate modified technique of renal transplantation model in rats. Methods Sprague-Dawley rats were selected as donors （ n = 21 ） and Wistar rats as recipients （ n = 42 ） . Renal allografts of both sides were harvested from the donors for renal transplantation. After resection of left kidney, end-to-end anastomosis of renal arteries between donor and recipient was performed by the assistance of home-made catheter. And end-to-end anastomosis between recipient＇s renal vein and donor＇s inferior vena cava was also performed. The donor＇s ureter with bladder patch was anastomosed to the recipient＇s bladder. Finally the right kidney was removed, cefminox （ 10 mg） was injected intraperitoneally, and then the abdominal cavity was closed. The operation data were recorded, including the operation time, artery and vein anastomosis time, cold and warm ischemia time and so on. Living for 3 days after operation was regarded as a success model. The success rate of modeling was calculated and the cause of death was analyzed. Results The operation time of donor was （ 32. 7 ± 5.6） min, and repair time for kidney was （4. 2 ± 1.1 ） min. The operation time of recipient was （42. 3 ± 42. 3 ） min, including （ 10. 1 ± 3.2 ）min of the artery anastomosis time, （ 13.9 ±2. 5 ） min of vein anastomosis time, （6. 3 ± 1.4） min of urinary tract reconstruction time. Warm ischemia time was （5. 4± 1.8 ） s, and cold ischemia time was （56. 2 ± 7.3 ） min. In 42 recipient rats, 40 rats were successful modeling and the success rate was 95.2%. Two rats died. One died of artery anastomosis hemorrhage, and the other died of diffuse peritonitis caused by urine leakage. Conclusions Renal transplantation model in rats with modified vascular end-to-end anastomosis has the characters of simple handling, short operation time and highsuccess rate.