大鼠原位肝移植模型不同灌注方式和吻合方法的效果比较

Effect of different perfusion and anastomosis methods in rat orthotopic liver transplantation model

目的分析不同灌注方式和不同肝上下腔静脉吻合方法对建立大鼠原位肝移植模型的影响。方法将80只SD大鼠随机分为供肝获取组和受体肝移植组,每组40只。供肝获取组10只大鼠采用腹主动脉输液器滴灌法(1滴/s),10只大鼠采用腹主动脉微量泵灌注法(6 mL/min),之后分别进行受体肝移植(每组对应10只大鼠肝移植),收集2组大鼠的供肝灌注时间和供肝获取时间,并于灌注后、肝移植24 h取肝脏组织行HE染色。受体肝移植组10只大鼠肝移植时采用连续吻合法,10只采用减张力半针吻合法(2组均在成功完成10只肝移植后截止),收集2组大鼠的肝上下腔静脉吻合时间、无肝期时间和术后发生并发症发生情况。结果与腹主动脉输液器滴灌组比较,腹主动脉微量泵灌注组的供肝灌注时间和供肝获取时间较短(P<0.05);HE染色结果显示,腹主动脉微量泵灌注组的肝细胞、门静脉及胆管形态学无明显改变,仅个别淋巴细胞浸润。与连续吻合组比较,减张力半针吻合组大鼠的肝上下腔静脉吻合时间和无肝期时间较短(P<0.05),术后吻合口出血和供肝灌注不全发生率较低(P<0.05)。结论相对于腹主动脉输液器滴灌法,腹主动脉微量泵灌注法能提高供肝质量;与连续吻合法比较,减张力半针吻合方法能缩短无肝期与肝上下腔静脉吻合时间,同时降低吻合口出血的发生率。

Objective To analyze the effects of different perfusion and different superior hepatic vena cava anastomosis methods on the establishment of rat orthotopic liver transplantation model.Methods Eighty SD rats were randomly grouped with donor group and recipient group with 40 rats in each group.Ten rats in the donor liver acquisition group received abdominal aorta infusion set drip irrigation(1 drop/s);10 rats received abdominal aorta micropump perfusion method(6 mL/min);and then received recipient liver transplantation(corresponding to 10 rats in each group).The donor liver perfusion time and donor liver acquisition time of rats in the 2 groups were collected.HE staining was performed on liver tissues after perfusion and 24 h after liver transplantation.Ten rats in the recipient liver transplantation group received continuous anastomosis,and 10 rats received tension-reducing half-needle anastomosis.We collected the anastomosis time of superior and inferior hepatic vena cava,the time of anhepatic stage and the incidence of postoperative complications of the recipient.Results Contrasted with abdominal aorta infusion group,the perfusion time and acquisition time of donor liver were shorter in the abdominal aorta micro-pump perfusion group(P<0.05).HE staining showed that the morphology of hepatocytes,portal vein and bile duct in the abdominal aorta micropump perfusion group did not change obviously,only a few lymphocytes infiltrated.Contrasted with continuous anastomosis group,the anastomosis time,anhepatic stage of the superior hepatic vena cava,incidences of postoperative anastomotic bleeding and incomplete perfusion of donor liver in the reduced tension half-needle anastomosis group were shorter or lower(P<0.05).Conclusions Compared with abdominal aorta infusion set drip method,the quality of donor liver was improved by abdominal aorta micropump perfusion.Compared with continuous anastomosis method,the tension-reducing half-needle anastomosis can shorten the suture time of superior hepatic vena cava and anhepatic stage,and the incidence of anastomotic bleeding was reduced.