大鼠颈部心脏移植中动脉套叠吻合的应用

APPLICATION OF SLEEVE ANASTOMOSIS IN DEVELOPMENT OF CERVICAL HEART TRANSPLANTATION IN RATS

目的 探讨采用动脉套叠吻合结合套管连接技术 ,制作大鼠颈部心脏移植模型 ,以简化手术操作 ,提高成功率。 方法 模型通过将供心无名动脉套叠吻合于受体右颈总动脉 ,供心肺动脉套接于受体右颈外静脉 ,将雄性SD大鼠 (2 5只 )心脏移植于 Wistar大鼠 (2 5只 )颈部。术后应用环孢霉素 A (1.5 mg/ kg,q.d.)灌胃治疗 ,通过视诊和触诊观察移植心存活情况 ,以存活超过 3天为手术成功标准 ,观察期 3个月。 结果 正式实验 2 5例 ,平均手术时间为(48.7± 3.4 )分钟 ,手术成功 2 2例 ,成功率为 88%。失败 3例为吻合口出血 1例 ,血栓形成 2例。观察期内死亡 6例 ,原因为肺部感染、颈部脓肿、肝脏或膀胱肿瘤 ,其余 16例大鼠移植心存活均超过 3个月。 结论 改进的大鼠颈部心脏移植手术模型具有操作简便 ,心脏缺血时间短 ,便于观察等优点。

Objective To simplify surgical technique and increase postoperative survival rate, sleeve anastomosis technique combined cuff technique was used in developing the model of cervical heart transplantation in rats. Methods In this model, the hearts from 25 male SD rats were transplanted into the neck of Wistar rats by anastomosing the donor innominate artery to the recipient right common carotid artery by use of sleeve technique, and the donor pulmonary artery to the recipient right external jugular vein by use of cuff technique. After operation, the rats were treated with cyclosporine A (1.5mgkg, q.d.), transplanted hearts were followed by daily inspection or palpation and the allograft survival time was more than 3 days as the standard of successful operation. Results The mean operative time was (48.7±3.4) min, with a successful rate of 88%(2225). Complications were anastomotic hemorrhage( 1 case) and thrombosis(2 cases). During the follow-up period, 6 rats died of pulmonary infection, abscess in the neck, liver or bladder tumor. The remaining 16 transplanted hearts survived more than 3 months. Conclusion The modified operation have advantages of less operative procedure, shorter operation and ischemia time and easier monitoring of graft function.