猪到猴异位辅助性肝移植模型的建立  

Establishment of Swine to Monkey Auxiliary Heterotopic Liver Transplantation Model

作　　者：陈云飞[1] 张恒 杨洪吉[1] 

机构地区：[1]四川省医学科学院.四川省人民医院器官移植中心,四川成都610072 [2]攀钢总医院普外科,四川攀枝花617000

出　　处：《中国普外基础与临床杂志》2013年第9期1006-1012,共7页Chinese Journal of Bases and Clinics In General Surgery

基　　金：国家自然科学基金资助项目(项目编号:81072445/H1006);四川省杰出青年基金资助项目(项目编号:08ZQ026-028)~~

摘　　要：目的建立长白小家猪到恒河猴异位辅助性肝移植模型，总结手术操作要点。方法以健康雄性长白小家猪和健康恒河猴各5只建立猪到猴异位辅助性肝移植模型。以长白小家猪作为肝移植供体，以恒河猴作为受体。保留长白小家猪的右后叶和部分右前叶作为供肝，移植到受体的左肾窝和左结肠旁沟处。短暂阻断受体的腹主动脉和下腔静脉血流后，将移植肝的门静脉和肝下下腔静脉分别与受体的腹主动脉和下腔静脉行端侧吻合。结扎移植肝的肝动脉，不予重建。术后观察受体的一般情况和生存时间。结果成功建立4对肝移植模型，供肝切取时间24～35min、（30±5）min，供肝修整时间31～51min、（40±10）min，受体下腔静脉阻断时间23～36min、（30±6）min，受体腹主动脉阻断时间22～38min、（30±8）min，肝移植手术时间130～310min、（220±80）min，术中失血35～48mL、（42±6）mL。术后均无吻合口血栓形成及胆漏发生。4只受体分别于术后48、54、88及96h死亡，死亡原因均为排斥反应及术中失血过多。结论猪到猴异位辅助性肝移植模型的可重复性强、手术易操作、移植器官灌注良好，可用于猪到非人类灵长类动物肝移植的进一步研究。Objective To establish the swine to monkey auxiliary heterotopic liver transplantation model and to summarize surgical points. Methods Five healthy landrace piglets and five rhesus monkeys were adopted to establish the xenogenic auxiliary heterotopic liver transplantation model. In our trail landrace piglets were treated as donor and rhesus monkeys were treated as receptor. Putting the transplanted liver which included right posterior segment and part of right anterior segment into rhesus＇ nest and left paracolic sulcus, and then blocking abdominal aorta and inferior vena cava shortly for end-to-side anastomosis in portal vein of transplanted liver and abdominal aorta of receptor, in infra-hepatic vena cava of transplanted liver and inferior vena cava of receptor. Ligation was performed at hepatic artery with no recon- struction. The postoperative situation and survival time of the receptors were observed. Results Four pairs of transplan- tation models were successfully established. The duration of donor liver harvesting, donor liver preparation, occlusion of recipient inferior vena cava, occlusion of abdominal aorta, and liver transplantation were （30±5） min （24 35 min）, （40± 10） min （31-51 min）, （30±6） rain （23-36 min）, （30＋8） min （22-38 rain）, and （220±80） min （130-310 min）, respectively. The blood loss during transplantation was （42± 6） mL （35-48 mL）. There were no thrombosis of the anas- tomosis and biliary fistula in receptors after operation, but 4 receptors died at 48, 54, 88, and 96 hours after liver transp- lantation respectively. Conclusions Swine to monkey auxiliary heterotopic liver transplantation model has strong repea- tability, operation procedure is easy, and transplanted organ of it have good perfusion, which can be available for variouskinds of basic and preclinical researches.

关 键 词：异种辅助性肝移植 长白小家猪 恒河猴 

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