猪原位辅助性部分肝移植治疗急性肝功能衰竭的模型  

Auxiliary partial orthotopic liver transplantation for acute hepatic failure: establishment of a new model

作　　者：吴伟顶[1] 彭承宏[1] 肖卫东[1] 周光文[1] 张明钧[1] 陈辉星[1] 舒明[1] 张弘炜[1] 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,现在浙江省人民医院200025

出　　处：《中华器官移植杂志》2005年第12期709-712,共4页Chinese Journal of Organ Transplantation

基　　金：上海市科技发展基金资助项目(02DJ14038)

摘　　要：目的建立猪原位辅助性肝移植(APOLT)治疗急性肝功能衰竭的动物模型,并评价其治疗效果。方法选取健康雌性良种幼猪18头,其中12头建立急性肝功能衰竭模型,另6头作为肝移植的供者。将急性肝功能衰竭的幼猪随机平均分为2组:对照组,不作任何处理;实验组,进行APOLT术,切除受者肝脏左叶,将修整后的供肝右叶移植于原肝左叶肝床处,供肝肝上下腔静脉与受者肝肝上下腔静脉行端侧吻合,供肝门静脉与受者肝门静脉行端侧吻合,受者脾动脉在结肠后与供肝动脉行端端吻合,胆总管置管外引流。结果对照组7d生存率仅为17%,而实验组为83%。实验组术后第7d肝功能基本恢复正常,组织学检查示原肝细胞再生明显。结论门静脉注射氨基半乳糖+脂多糖诱导的猪急性肝功能衰竭是一个理想的动物模型;APOLT对急性肝功能衰竭具有较好的疗效。Objective To establish the model of auxiliary partial orthotopic liver transplantation （APOLT） and evaluate its supporting effect on acute liver failure. Methods Eighteen healthy female domestic pigs weighing between 20 to 30 kg were used as donors and recipients. Acute liver failure in 12 porcine was successfully induced by injection of galactoramine and lipopolysaccharide through portal vein. In the treated group, the recipients underwent APOLT, left lobes of the recipients were resected and right lobes of donors were implanted orthotopically. The suprahepatic cava veins of right liver grafts were implanted end-to-side on the recipient＇s suprahepatic cava veins. The portal veins of the grafts were implanted end-to-side on the recipient＇s portal veins. The native bile duct was left intact, and ex situ graft biliary drainage was performed with a silicone tube. The donor artery was implanted side-to-side on the recipient＇s splenic artery. Results Seven-day survival rate of the porcine with acute liver failure was only 17%, while in the porcine receiving APOLT, the 7 day survival rate was 83%. The liver function returned near to normal level on the 7th postoperative day and regeneration of the native liver was confirmed histologically. Conclusion It is suggested that acute liver failure induced by injection of galactoramine and lipopolysaccharide is an ideal model and pigs suffering from fulminant hepatic failure could achieve long survival and liver regeneration with a temporary support of the auxiliary graft.

关 键 词：肝功能衰竭 急性 猪 肝移植 

分 类 号：R657.3[医药卫生—外科学]