活体犬供肾腹腔镜切取-肾移植模型的建立  

Establishment of model of laparoscopic living donor nephrectomy-kidney transplantation in canine

作　　者：谢茂[1] 于胜强[1] 门昌平[1] 王琳[1] 高振利[1] 

机构地区：[1]烟台毓璜顶医院泌尿外科,山东264000

出　　处：《器官移植》2011年第5期249-252,共4页Organ Transplantation

基　　金：山东省自然科学基金项目(Y2008C49)

摘　　要：目的探讨采用腹腔镜行犬活体供肾切取术并建立同种异体肾移植动物模型的可行性。方法 8只Beagle犬随机编号配对,供、受体犬左侧肾脏互换。采用腹腔镜行供肾切取术获取左侧肾脏,灌洗修剪完毕后将供肾动、静脉分别与受体髂外动、静脉行端侧吻合,供肾输尿管与受体膀胱行抗返流吻合,并置于实验犬左侧髂窝,同时切除受体右侧肾脏,术后口服免疫抑制剂。观察记录供肾切取时间,供肾热缺血时间,术中失血量,供肾动、静脉长度等,以及实验犬术后血清肌酐(Scr)、血尿素氮(BUN)等指标。结果 8例腹腔镜活体供肾切取术均获得成功,手术时间为(61.5±11.0)min,术中失血量为(13.9±6.8)ml,供肾热缺血时间为(81.4±9.3)s,肾动脉长度为(1.2±0.2)cm,肾静脉长度为(1.5±0.3)cm;8例同种异体肾移植术手术时间为(87.3±13.9)min,术中失血量为(15.7±5.2)ml,术后3d实验犬的Scr、BUN恢复正常,1例术后4d死于吻合口动脉血栓,余7例在术后1个月观察期间内无发生漏尿、出血、感染等并发症。结论采用腹腔镜技术行犬活体供肾切取术安全可靠,同时建立肾移植动物模型的方法操作简便、容易掌握,成活率较高。Objective To investigate the feasibility of using laparoscopic nephrectomy in canine living donor for establishing the model of allogeneic kidney transplantation. Methods Eight Beagle canines were paired by using a random number generator and the left kidneys of donor and recipient were exchanged. The left kidneys were harvested under laparoscopy. After perfusion and trimming, reconstruction of renal circulation was made by end-to-side anastomosis of the renal vessels of donor and external iliac vessels of recipient. The ureter of the donor kidney was anastomosed to the recipient＇s bladder with an anti-reflux way. And all kidneys were transplanted to the recipients＇ left iliac fossa. Then the right kidneys of all recipients were removed. After surgery, oral anti-rejection drugs were given to the recipients. The operating time of laparoscopic nephrectomy, the kidney warm ischemia time, blood loss volume during the operation, length of recipients＇ artery and vein, the canine serum creatinine （Scr） and blood urea nitrogen （BUN） were observed and recorded. Results Eight cases of laparoscopic nephrectomy were successfully performed. The average time of nephrectomy was （61.5± 11.0） minutes. The blood loss volume of nephrectomy was （ 13.9 ±6. 8） ml, and the kidney warm ischemia time was（ 81.4 ±9. 3 ） seconds. The length of renal artery and vein were（ 1.2±0. 2 ） cm and （ 1.5 ± 0. 3 ） cm respectively. The operation time of transplantation was （ 87.3 ±13.9 ） minutes. The blood loss volume of transplantation was （ 15.7 ±5.2 ） ml. On day 3 post-operation, the Scr and BUN levels of all canine recipients recovered to normal. One canine recipient died of anastomotic artery thrombosis on day 4 after the transplantation. During the one month follow-up, no leakage of urine, no bleeding, no infection or other complication was occurred in the other 7 cases. Conclusion Laparoscopic living donor nephrectomy can be successfully performed in canine and it is also simple and practicable to

关 键 词：腹腔镜 活体供肾 肾移植 动物模型 

分 类 号：R699.2[医药卫生—泌尿科学]