改良犬背驮式减体积肝移植的实验研究

Experimental and Clinical Study of Piggyback Reduced-size Orthotopic Liver Transplantation in Dogs

目的探讨犬背驮式减体积肝移植的可行性。方法28只犬随机分成两组,实验组(14只)采用背驮式减体积肝移植术,对照组(14只)采用传统的背驮式肝移植术。术中均采用静脉转流术。结果实验组术后存活4只,对照组术后存活5只。在手术时间和腹腔引流量上实验组明显长于对照组(P<0.01,P<0.05),但在冷缺血时间、无肝期时间和胆汁引流量方面无统计学差异(P>0.05)。肝细胞凋亡随时间逐渐加重,但无统计学意义(P>0.05)。结论(1)大动物肝移植实验是临床肝移植的必要技术准备;(2)犬是背驮式减体积肝移植理想的动物实验模型。

Objective To investigate the operative procedures and perio pr ative managements of piggy-back reduced size orthotopic liver transplantation( PBRSOLT)in dogs.Methods 28dogs were randomly divided into2groups(14as ex perimental and14as control group).PBRSOLT was performed in experimental grou p whereas piggy back orthotopic liver transplantation(PBOLT)was performed in c ontrol group.Bypass bridge between portal vein and IVC in both groups was estab lished.Results4dogs in experimental group and5dogs in control group were surv ived after operation.Operative time in experimental group was longer than that of control group(P<0.01).But there was no significantly difference in cold ischemia and anhepatic period between2groups(P>0.05).Mean bile exc retion volume after operation in experimental and control group were14.7± 10.1ml/day and16.8±12.5ml/day,respectively.No significant dif ference was seen(P>0.05).Mean abdominal drainage volume after operation in experimental and control group were269±112.4ml/day and126.9 ±55.8ml/day,respectively;there was a significantly difference(P<0. 05).The longer the survival time,the more apoptosis of hepatic parenchymal cells was found in both groups(P>0.05).Conclusions (1)Experimental pe rformence of liver transplantation in large animals is necessary technique train ing.(2)The canine PBRSOLT is an ideal animal experiment model.