六基因修饰巴马小型猪活体供肾切取研究报告  

Research report of living donor kidney harvesting in Bama miniature pigs with six gene modified

作　　者：许勇 宋翔宇 王恒恩 杨树军 贾志博 卫浩 陈胜峰 崔梦一 任延玲 彭江 孙圣坤 Wang Heng’en;Yang Shujun;Jia Zhibo;Wei Hao;Chen Shengfeng;Cui Mengyi;Ren Yaning;Peng Jiang;Sun Shengkun(Department of Urology,the Third Medical Center of Chinese People’s Liberation Army General Hospital,Beijing 100000,China)

机构地区：[1]中国人民解放军总医院第三医学中心泌尿外科,北京100000 [2]河北北方学院研究生院 [3]兰州大学第二医院泌尿外科 [4]青岛大学附属医院泌尿外科 [5]中国人民解放军总医院第四医学中心骨科 [6]军事科学院军事医学研究院实验动物中心

出　　处：《器官移植》2024年第2期229-235,共7页Organ Transplantation

基　　金：国家重点研发计划(2019YFA0110704)。

摘　　要：目的总结基因修饰猪活体供肾切取的经验及其实践价值。方法采用活体供肾切取技术,切取六基因修饰猪左侧肾脏。首先阻断输尿管,游离下腔静脉及腹主动脉后,切取过程中依次完成输尿管、肾静脉、肾动脉的显露、游离。在腹主动脉、下腔静脉上阻断钳,离断肾动脉、静脉后立即用4℃肾保存液进行灌注,保存在冰生理盐水中准备移植。同时完成供体腹主动脉、下腔静脉缺口的缝合。记录手术时间,出血量,热缺血和冷缺血时间,并发症发生情况以及供、受体存活情况。结果成功切取基因修饰猪左肾,取肾术中出血5 mL,热缺血时间45 s,冷缺血时间2.5 h。供、受体均未输血,植入受体内的肾脏恢复泌尿功能。切取左肾后供体健康存活8个月余。结论基因修饰猪活体供肾切取技术安全可靠,游离肾脏过程中同时处理分支血管,减少了修肾过程,缩短了冷缺血时间,活体供肾切取有助于后续供体存活并进行其他科学研究。Objective To summarize the experience and practical value of living donor kidney harvesting in Bama miniature pigs with six gene modified.Methods The left kidney of Bama miniature pigs with six gene modified was obtained by living donor kidney harvesting technique.First,the ureter was occluded,and then the inferior vena cava and abdominal aorta were freed.During the harvesting process,the ureter,renal vein and renal artery were exposed and freed in sequence.The vascular forceps were used at the abdominal aorta and inferior vena cava,and the renal artery and vein were immediately perfused with 4℃renal preservation solution,and stored in ice normal saline for subsequent transplantation.Simultaneously,the donor abdominal aorta and inferior vena cava gap were sutured.The operation time,blood loss,warm and cold ischemia time,postoperative complications and the survival of donors and recipients were recorded.Results The left kidney of the genetically modified pig was successfully harvested.Intraoperative bleeding was5 mL,warm ischemia time was 45 s,and cold ischemia time was 2.5 h.Neither donor nor recipient pig received blood transfusion,and urinary function of the kidney transplanted into the recipient was recovered.The donor survived for more than 8 months after the left kidney was resected.Conclusions Living donor kidney harvesting is safe and reliable in genetically modified pigs.Branch blood vessels could be processed during kidney harvesting,which shortens the process of kidney repair and the time of cold ischemia.Living donor kidney harvesting contributes to subsequent survival of donors and other scientific researches.

关 键 词：异种移植 活体供肾 肾切除术 终末期肾病 肾移植 供肾获取 基因修饰猪 微创技术 

分 类 号：R617[医药卫生—外科学] R692[医药卫生—临床医学]