不同比例缩小体积肝移植的大动物研究  

Reduced-size liver transplantation of different graft ratio in a porcine model

作　　者：尹路[1] 周光文[1] 樊嘉[2] Madariaga Juan R 彭承宏[1] 张启瑜[4] 虞冠峰[4] 臧运金[5] 吴德全[6] 陈谦[7] Costa Guilherme 朱岳 Fung John J 李宏为[1] 

机构地区：[1]上海第二医科大学附属瑞金医院外科 [2]上海医科大学附属中山医院肝胆外科 [3]Thomas E.Starzl Transplantation Institute,University of Pittsburgh [4]温州医学院附属第一医院外科 [5]山东医科大学附属千佛山医院外科 [6]哈尔滨医科大学附属第二医院普外科 [7]桂林医学院附属第一医院外科

出　　处：《中华普通外科杂志》2005年第8期470-473,共4页Chinese Journal of General Surgery

摘　　要：目的研究不同比例缩小体积肝移植的结果,确定猪能耐受的最小体积的肝移植。方法远系繁殖猪70头分为原位全肝移植作为对照组和3组不同比例缩小体积原位肝移植(按照缩小体积的移植肝占受体切除肝脏重量的百分比;1组:60%;2组:30%;3组:20%);实验采用原位经典肝移植方式(静脉转流)。术后第3天和第5天取肝标本。结果对照组和3组不同比例缩小体积肝移植的移植物与受体肝脏重量百分比(GIWRW)分别为87·4%±8·3%、59·9%±5·2%、33·6%±4·9%和22·1%±3·4%;移植物与受体体重百分比(GIWBW)分别2·4%±0·4%、1·43%±0·17%、0·81%±0·09%和0·53%±0·06%。对照组、1组和2组存活率达100%;3组存活率仅为53%。4个组的动物处死后肝脏移植物重量均有显著的增加。结论安全的缩小体积肝移植,应以移植物与受体肝脏重量百分比不小于33%,同时移植肝与受体重量百分比不小于0·8%为限。Objective To determine the smallest possible liver graft in reduced-size liver transplantation in a porcine model. Methods Seventy porcines weighing 17 - 34 kg were divided into four groups according to the percentage of reduced-size donor graft liver weight over the resected recipient liver weight （ GIWRW ） （ whole liver control group, Group- Ⅰ ： 60% , Group- Ⅱ ： 30% , Group- Ⅲ ： 20% ）. Orthotopic liver transplantation was performed with venovenous bypass. The liver graft was harvested on postoperative third and fifth day respectively. Results GIWRW in the four groups was 87.4% ± 8.3%, 59.9% ± 5.2%, 33.6% ± 4. 9% and 22. 1% ± 3.4% respectively. GIWBW （ graft over recipient body weight）in the four group was 2.4% ±0.4%, 1.43% ± 0. 17%, 0.81% ± 0.09% and 0.53% ±0.06% respectively. The survival rate in group- Ⅰ ,group-Ⅱ and control was 100% at the time when the porcines were sacrificed on post-operative fifth day. The survival rate of group-Ⅲ was 53%. The liver grafts in the four groups all remarkably regenerated. Conclusions In reduced-size liver transplantation it is safe when the ratio of graft weight over recipient liver weight is above 33%, and the ratio of graft liver weight over recipient weight is above 0. 8%.

关 键 词：移植体积 肝移植 动物模型 猪 流出道梗阻 

分 类 号：R657.3[医药卫生—外科学] R-332[医药卫生—临床医学]