大鼠40%小体积肝移植动脉化模型建立及移植肝的病理观察  

Establishment of Arterialized Small-for-Size Liver Transplantation Model and Investigation of Histopathologic Changes of Grafts in Rats

作　　者：徐贵云[1] 江艺[2] 陈海燕[3] 潘凡[2] 

机构地区：[1]淮安市第二人民医院普外科,江苏淮安223002 [2]全军器官移植中心福州总医院南京军区肝胆外科研究所,福州350025 [3]淮安市第二人民医院检验科,江苏淮安223002

出　　处：《中国普外基础与临床杂志》2009年第3期180-183,共4页Chinese Journal of Bases and Clinics In General Surgery

基　　金：福建省科技基金资助项目(项目编号:2004Y004)~~

摘　　要：目的建立稳定的大鼠40%小体积肝移植动脉化模型,并观察术后移植肝的病理变化。方法采用改良二袖套法建立大鼠40%小体积肝移植动脉化(供鼠腹腔动脉与受鼠右肾动脉套入式吻合)模型,观察7 d生存率,并于术后1、2、4及7 d检测肝功能及观察移植肝组织学变化。结果手术成功率为93.3%,7 d生存率为60.0%,无肝期平均(12.0±2.5)min,丙氨酸转氨酶(ALT)、总胆红素(TB)于术后第1天即明显增高,第2天达高峰,以后逐渐降低。组织学检查显示,术后第1天可见中央静脉及肝窦扩张,汇管区有较多单核细胞浸润;术后第4天可见较多二倍体和多倍体肝细胞。结论通过技术改进,简化了手术操作,提高了手术成功率及模型的稳定性。缺血及门静脉高压力再灌注损伤是移植肝病理改变的根本原因。Objective To establish and modify a rat model of arterialized small-for-size orthotopic liver transplantation and investigate the histopathologic changes of the grafts after transplantation. Methods Modified twocuff technique was applied to establish a rat model of 40 % small-for-size orthotopic liver transplantation with a modified microvascular ＂sleeve＂ anastomosis between the celiac trunk of donors and the stump of right kidney artery of recipients. Seven days survival rate was observed, main indices of liver function, histopathologic changes of the grafts were detected on the 1st, 2nd, 4th and 7th day after transplantation, respectively. Results The successful rate of operation was 93.3%. Seven days survival rate was 60.0%. The mean time of nonhepatic time was （12.0±2.5） rain. Alanine aminotransferase （ALT） and total bilirubin （TB） began to elevate on the first day and peaked on the second day after operation. Histological findings indicated that hepatic sinusoidal and central vein dilation, monocytes infiltration in partial area were found on the 1st day after operation, more diploid and polyploid hepatocytes could be observed on the 4th day after operation. Conclusion The model is easily available and highly reproducible, and the stability of the model is improved by modifying the technique. The histological changes of the grafts are mainly caused by ischemia-reperfusion injury.

关 键 词：小体积肝移植 模型 肝动脉 移植肝 

分 类 号：R657.3[医药卫生—外科学]