大鼠辅助性肝-小肠联合移植模型

Surgical technique for combined intestine-auxiliary liver transplantation in rats: development of a new microsurgical model

目的 介绍一种新的大鼠辅助性肝 -小肠联合移植模型。方法 整块切取全部小肠和6 0 %的肝脏。同时切取腹腔动脉及肠系膜上动脉的动脉段以确保移植器官的血供。供体小肠的静脉血通过供体完整的门静脉回流。将供体左肾静脉水平肝下下腔静脉斜形切断吻合于受体两肾静脉之间的下腔静脉 ,供体腹主动脉和受体腹主动脉端侧吻合。切除受体的小肠 ,通过小肠端 -端吻合重建肠道。结果 整个手术时间平均为 130min。 3个月的生存率为 8% (16 2 0 )。移植后 90d ,对 3只大鼠行剖腹探查及组织学检查 ,观察到移植物的形态及功能均正常。观察移植后 12个月的 5只大鼠 ,肝功能正常 ,移植肝及小肠均呈正常的组织学结构。结论 大白鼠辅助性肝 -小肠联合移植是可行的。

Objective Combined liver-intestine transplantation is an evolving procedure, and auxiliary liver transplantation has several advantages over standard orthotopic liver transplantation. We present a new model of combined intestine-auxiliary liver transplantation in rats. Methods Total small bowel and 60% of the liver were harvested en bloc. An aortic segment that contained the celiac axis and superior mesenteric artery ensured the blood supply to the graft. Venous drainage of the grafted intestine was achieved via the intact portal vein of the graft. Revascularization was accomplished by end-to-side anastomosis of the aorta and of the infrahepatic vena cava. The recipient small bowel was resected and the intestine continuity was restored by anastomosis. Results Total operation time averaged 130 minutes. The 3-month survival rate was 80% (16/20). Exploratory laparatomy and histological examination in 3 rats on 90th day after transplantation revealed normal and viable grafts. Liver function was normal and both grafted liver and intestine showed normal histologic architectures in 5 rats observed 12 months after transplantation. Conclusions The present model is reproducible and help for preclinical research on several aspects of experimental combined intestine-auxiliary liver transplantation.