心脏停搏供体大鼠供肝热缺血对原位肝移植物的影响  

Influence of warm ischemia reperfusion of the donor liver from non-heart-beating donors on the graft in rat orthotopic liver transplantation

作　　者：张宝良[1] 刘彤[2] 

机构地区：[1]河北医科大学附属唐山工人医院普通外科,河北省唐山市063000 [2]天津医科大学总医院普通外科,天津市300052

出　　处：《世界华人消化杂志》2008年第32期3681-3686,共6页World Chinese Journal of Digestology

摘　　要：目的:探讨来自心脏停搏供体大鼠肝移植供肝热缺血再灌注损伤对移植物的影响.方法:实验分为4组:对照组(C)和移植组,移植组根据供肝获取前经历供体心脏停搏时间的不同分为3组:热缺血0min(W0组)、热缺血15min(W15组)和热缺血30min(W30组),其后用建立大鼠动脉化原位肝移植模型,每组均为24只大鼠,分别测定术后3、7、14和30d移植肝组织学、肝功能和细胞增殖核抗原Ki-67蛋白的变化,每个时间点各取6只大鼠处死.结果:随着供肝热缺血时间的延长,移植肝损伤加重,并且恢复过程也延长.移植组和对照组术后第3、7、14和30天血清ALT、AST均无显著性改变.肝移植术后早期肝细胞Ki-67表达水平随供肝热缺血时间的延长而增高,术后14d恢复正常.各组的肝细胞Ki-67表达均与血清ALT、AST无关.结论:肝移植过程中供肝热缺血主要损伤肝细胞,并随着供肝热缺血时间的延长移植肝细胞损伤加重,肝细胞功能恢复早于其形态学恢复.AIM： To investigate the effect on graft of warm ischemia reperfusion injury following orthotopic liver transplantation from non-heart beating donors in rats. METHODS： The rats were divided into four groups （n = 24/group） including the control group and 3 liver transplantation groups in which cardiac arrest time was respectively 0, 15, 30 rain （W0, W15, W30）. The model of orthotopic liver transplantation with arterial reconstruction was established. Six rats in each group each time were sacrificed on 3, 7, 14 and 30 days after surgery, respectively. Histological features, hepatic function and Ki-67 were detected. RESULTS： Histological studies showed that longer warm ischemia time increased the liver restoration time as well as aggravated liver parenchyma injury. Serum levels of alanine transaminase （ALT） and aspartate transaminase （AST） in all groups showed no marked difference on 3, 7, 14 and 30 days after surgery. The proportion of Ki67-labeled hepatocytes increased with the warm ischemia time of the graft and returned to normal on day 14 postoperatively. In all the groups, the proportion of Ki67-labeled hepatocytes showed no significant correlation with ALT and AST. CONCLUSION： The main site of warm ischemia of the graft is the hepatocyte. The injury of hepatocyte aggravates with warm ischemia time of the graft. Restoration of the function is faster than restoration of the morphology.

关 键 词：再灌注损伤 肝移植 热缺血 大鼠 心脏 停搏 

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