重建肝动脉血液供应和胆道外引流的大鼠原位肝移植模型的建立  

Construction of an arterialized rat liver transplantation model with biliary extra-drainage

作　　者：陈耿[1] 张玉君[1] 杨程[1] 郑树国[1] 李昆[1] 董家鸿[1] 

机构地区：[1]第三军医大学附属西南医院全军肝胆外科研究所解放军西南肝胆外科医院,重庆400038

出　　处：《中华器官移植杂志》2006年第1期40-43,共4页Chinese Journal of Organ Transplantation

基　　金：国家自然科学基金资助(30571834)

摘　　要：目的构建一个稳定的重建肝动脉血液供应和胆道外引流的大鼠原位肝移植模型,为肝移植术后胆道问题的研究提供一个更加符合正常生理的动物实验平台。方法在经典的“双袖套”法的基础上,将与肝动脉相连的供者主动脉直接与受者的腹主动脉行端侧吻合,重建肝动脉血液供应,同时横断受者的胆总管,行胆道外引流和空肠造瘘,重建胆汁回流通路,以维持肠肝循环。结果共施行改良的大鼠原位肝移植31次,成功28次,手术成功率为90.32%,术后受者24h存活率为80.65%(25/31),术后1周存活率为74.19%(23/31),术后1个月存活率为70.97%(22/31)。结论用带肝动脉的供者主动脉直接与受者的腹主动脉行端侧吻合重建肝动脉血液供应可靠、易行,通过建立体外胆汁回流通路不仅能有效维持肠肝循环,而且便于胆汁采集。该模型易于标准化,是研究肝移植术后胆道问题的理想动物模型。Objective To establish a stable orthotopic liver transplantation （OLT） model with hepatic artery reconstruction and biliary extra-drainage in rats and to provide a more physiological platform for the study of biliary problems after liver transplantation. Methods Based on the traditional ＂two cuff＂ techniques, end-to-side anastomosis between the aortas of donor and recipient was performed to reconstruct hepatic artery blood flow. The common bile duct was transected. Biliary extradrainage and enterostomy were performed to re-build bile flow passageway and to maintain enterohepatic circulation. Results Thirty-one cases of modified rat liver transplantation were done during this study. The successful rate of operation was 90. 32 %. The 24 h- one week- and one month-survival rate posttransplant was 80. 65 %, 74. 19 % and 70. 97 % respectively. Conclusion The method of hepatic artery flow reconstruction is proved to be relatively reliable and easy. The reconstruction of bile flow passageway not only maintains the enterohepatic circulation, but also provides a convenient way to collect bile. This animal model is easy to standardize and may meet the need for the study of posttransplant biliary problems.

关 键 词：肝移植 模型 动物 肝动脉 肝循环 大鼠 

分 类 号：R657.3[医药卫生—外科学] R322.12[医药卫生—临床医学]