猪辅助性异位部分肝移植

Auxiliary heterotopic partial liver transplantation in pigs

目的 探讨辅助性异位部分肝移植治疗急性缺血性肝衰的效果。方法 用家猪配对行辅助性异位部分肝移植治疗急性缺血性肝衰。随机分为两组 :I组 ,受体肝脏保持原状 ,肝动脉结扎 ,门静脉缩窄 ,供肝右半肝植入受体右肝下 ,仅建立门静脉血供 ,不建立动脉血供 ;II组 ,供肝动脉和门静脉均建立血供 ,其它手术内容与I组相同。监测各组受体存活情况、肝功能、肝脏血流情况、病理及供肝胆汁分泌情况。结果 II组受体成活率显著高于I组。I组术后胆红素显著高于术前 ,II组手术前后胆红素无显著变化 ,I组术后胆红素显著高于II组。I组供肝无或仅有少量胆汁分泌 ,肝细胞大片坏死 ;II组供肝胆汁分泌和血供良好 ,肝细胞存活良好并有活跃的代偿性增生 ;I ,II组自体肝脏均大片坏死。结论 受体肝动脉结扎、门静脉缩窄能造成急性缺血性肝衰。辅助性异位部分肝移植可以治疗肝衰 ,效果良好。供肝必需建立良好的动脉血供。

Objective To investigate the effect of auxiliary heterotopic partial liver transplantation in treating acute ischemic liver failure. Methods Auxiliary heterotopic partial liver transplantation was performed on pigs.The pigs were divided into two groups.Group I: The host′ liver was preserved in situ, liver artery was ligated, portal vein was constricted,and donor patial right liver was transplanted under the right lobe of the liver of the host.Portal venous blood supply was constructed only, and arterial blood supply was not constructed .Group B:Except both arterial blood supply and portal venous blood supply of the donor liver were constructed, and the other operative procedures were as the same as in Group A. The living condition, liver function, blood supply, pathology and bile secretion of the donor liver were observed. Results The survival rates in Group B before and after operation were higher than that in Group A .Serum bilirubin(SB) after the operation was higher than that before the operation in Group A, but showed no change in Group B.After the operation, SB in Group A was higher than that in Group B. In Group A, the donor liver didn't secret bile,and hepatocytes were necrosis.In Group B, the bile secretion and blood supply of donor liver were good,and hepatocyte of the donor liver were alive and proliferating actively.The hosts' liver was necrosis obviously in both groups. Conclusions Hosts' liver artery ligation and portal vein constriction can result in acute ischemic liver failure.Auxiliary heterotopic partial liver transplantation is effective in correcting liver failure.The good arterial blood supply must be constructed in the donor liver to get good donor liver quality.