罂粟碱灌洗液能改善异种移植肝早期再灌注障碍

Papaverine Can Improve the Early Liver Reperfusion Failure in the Discordant Liver Xenotransplantation from Guinea Pig to Rat

目的 研究豚鼠至大鼠异种肝移植动物模型中移植肝再灌注障碍的原因和改善的方法。方法 采用Kamada方法建立异种肝移植动物模型 ,分为生理盐水灌洗组 (NS组 )和罂粟碱灌洗组 (PP组 ) ,检测受体门静脉直径、血流速度和血流量 ,并对移植肝行组织学检查。结果 NS组门静脉血流量为 ( 0 .3 2± 0 .0 6)mL s,PP组为( 0 .5 3± 0 .0 9)mL s,PP组门静脉压力差为NS组的 1.85倍。两组移植肝有相似的组织学变化 ,表现为肝细胞水样变性 ,中央静脉和小叶间静脉扩张淤血 ,但肝小叶结构存在。两组受体大鼠存活时间无显著性差别 (P >0 .0 5 )。结论 在该模型中 ,移植肝早期再灌注障碍由门静脉系统血管痉挛引起 ,可用罂粟碱灌洗液缓解 ,后期的再灌注障碍由超急性排斥反应 (HAR)引起 。

Purpose: To find the cause of liver reperfusion failure in the guinea pig to rat liver transplantation model and the way to alleviate it. Methods: The animal models were established by the way of Kamada's and were divided into two groups according to different perfusate of donor liver, i. e. normal saline (NS group) and papaverine (PP group). The velocity and quantity of portal vein were detected, histology of the grafts was observed. Results: The blood flow was (0.32 ± 0.06) mL/s in the NS group, and (0.53 ± 0.09) mL/s in the PP group. The difference of portal pressure in PP group was 1.85 times of that in NS group. There was similar histology in the two groups, which was hydropic degenerated liver cells and dilated blood vessels with blood stasis, but intact lobular structure. The survival time of the rats in the two groups was similar (P > 0.05). Conclusions: In this model, the early reperfusion failure of the liver is due to spasm of the portal system, which can be reversed by the papaverine, while the late reperfusion failure is due to hyperacute rejection occurred in the liver which lead to death of the recipient.