建立猪心脏移植至猕猴腹腔内的异位心脏移植模型  

Establishment of a model of pig-to-monkey abdominal heterotopic cardiac xenotransplantation

作　　者：陈刚[1] 陈实[1] 王西墨[1] 沈世乾[1] 王虹[1] 陈利君[1] 吴瑛[1] 朱建国[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院器官移植研究所,武汉430030

出　　处：《中华器官移植杂志》2006年第8期485-488,共4页Chinese Journal of Organ Transplantation

基　　金：国家高新技术研究发展计划资助项目(101-05-05-01)

摘　　要：目的 评价改进后的猪心脏移植至猕猴腹腔内的异位心脏移植模型的效果。方法 建立21例猪心脏移植至猕猴腹腔内的异位心脏移植模型，其中采用传统手术方法11例，改进方法10例。改进方法为缩短供心缺血时间，调整了手术顺序，先游离受者供吻合的腹主动脉及下腔静脉段后，再行供心切取，并且改进了切取供心的方法。比较2种手术方法的热缺血时间、移植心功能恢复情况及术后并发症。结果 采用传统手术方法时，移植心准备时间为20～30min，热缺血时间为3～5min，总缺血时间为80～90min，再灌注后均未恢复正常的全心搏动，仅见右心收缩，移植后发生并发症较多（包括出血、吻合口血栓形成、肠道并发症及静脉回流不畅等）。改进手术方法后，移植心准备时间为5～10min，热缺血时间〈1min，总缺血时间为35～40min，再灌注后有6例恢复全心搏动，发生并发症较少。结论 改进后的猪心脏移植到猕猴腹腔内的异位心脏移植模型，其手术方法明显优于传统方法。Objective To evaluate a modified model of pig-to-rhesus monkey abdominal heterotopic cardiac xenotransplantation. Methods Pig-to-monkey abdominal heterotopic heart transplants were performed with two different methods. Eleven transplants were subjected to traditional method, while the rest 10 to a modified one. In order to shorten the ischemia time of the cardiac xenografts, the order of donor and recipient surgeries was modulated with the modified method. The aorta and the inferior vena cava of recipients were identified in advance and then cardiac xenografts were harvested. Additionally, the method of donor operation was also modified. Results Using the traditional method, it took 20 to 30 min to prepare cardiac grafts. The warm ischemia time was between 3 to 5 min and the total ischemia time was between 80 to 90 min. None of the cardiac grafts in this group resumed normal pulsation after reperfusion （only contraction of the right cardiac ventricle was seen）, and the complications such as bleeding, stoma thrombosis, intestinal complication and venous return problem took place more often. In contrast, it only took 5 to 10 min to prepare cardiac grafts with the modified method. The warm ischemia time was between 3 to 5 min and the total ischemia time was between 80 to 90 min. Six of 10 grafts in this group resumed sinus rhythm with vigorous contraction after reperfusion, and those complications were less seen. Conclusion The modified model of pig-to-monkey abdominal heterotopic cardiac xenotransplantation was proved to be better than the traditional one.

关 键 词：心脏移植 移植 异种 猕猴 猪 

分 类 号：R-332[医药卫生]