大鼠心跳骤停复苏后肝移植供肝模型的建立

A novel rat model of orthotopic liver transplantation after cardiac arrest and cardiopulmonary resuscitation

目的建立一种稳定的大鼠心跳骤停复苏后供肝原位肝移植模型。方法在Kammada二袖套法的基础上进行改良，通过在供肝获取前夹闭供体腹主动脉5 min后再开放的方法来模拟供体移植前心跳骤停心肺复苏成功肝脏的血流动力学变化，关腹3 h后行大鼠原位肝移植，建立大鼠心跳骤停复苏后供肝肝移植模型。同时建立不夹闭供体腹主动脉的对照组，并检测供肝获取时两组供体血清谷丙转氨酶（ALT）和谷草转氨酶（AST）水平。结果共实施大鼠心跳骤停复苏后供肝原位肝移植手术50例，成功46例，手术成功率为92%。供、受体手术时间分别为（49±4） min和（54±5） min，无肝期为（17±2） min。供肝获取时夹闭组血清ALT水平为（73.2±8.7） U/L，AST水平为（204.9±28.8） U/L；而对照组ALT与AST水平分别为（46.1±5.4） U/L和（127.6±15.1） U/L，差异有统计学意义（P＝0.037、0.023）。结论在二袖套法基础上建立的大鼠心跳骤停复苏后供肝肝移植模型稳定、可靠、重复性强。本模型模拟了临床上供体捐献前曾出现过心跳骤停且成功复苏后供肝的血流动力学变化。

Objective To establish a stable rat model of orthotopic liver transplantation（OLT） after cardiac arrest and cardiopulmonary resuscitation （CPR）.MethodsThe OLT model was established using Kammada two-cuff technique with little modification. The donor rat’s abdominal aorta was clipped for 5 minutes to simulate the cardiac arrest and CPR before transplantation. The serum levels of alanine aminotransferase （ALT） and aspartate transaminase （AST） of the controlled group and the experimental group were examined before transplantation.ResultsOf the total 50 cases of surgery, 46 cases were successful, and the success rate of the model was 92%. The donor and recipient operation time was （49±4） min and （54±5） min, respectively. The anhepatic phase was （17±2） min. The serum levels of ALT and AST of the experimental group were significantly higher than that of the controlled group （P=0.037, 0.023）.ConclusionBased on the Kammada two-cuff technique, the rat model of OLT after cardiac arrest and CPR is stable, reliable and reproducible. The model simulated the cardiac arrest and CPR of the donor before liver transplantation, providing a new experimental method of studying the liver transplantation of this kind of donors.