• 南京醫(yī)科大學(xué)一附院肝移植中心(南京210029);

目的探討部分肝移植術(shù)后移植肝的再生問(wèn)題。方法建立大鼠部分肝移植模型,實(shí)驗(yàn)分為肝切除組(PLR組)、全肝移植組(OLT組)和部分肝移植組(POLT組)3組,分別于術(shù)后不同時(shí)間段取外周血檢測(cè)總膽紅素和谷丙轉(zhuǎn)氨酶水平; 取肝組織行組織學(xué)檢查及流式細(xì)胞儀檢測(cè)移植肝的增殖活性。結(jié)果移植術(shù)后1 w,肝功能酶學(xué)指標(biāo)增高,后逐步降低; 組織學(xué)檢查術(shù)后可見單核細(xì)胞浸潤(rùn),特別在門靜脈周圍匯管區(qū),肝實(shí)質(zhì)可見點(diǎn)狀壞死。術(shù)后1個(gè)月可見膽管增殖; PLR組和POLT組還可見二倍體和多倍體的肝細(xì)胞,中央小靜脈、肝竇和葉間靜脈輕度擴(kuò)張。 PLR組和POLT組肝細(xì)胞均增生活躍,3組分別于術(shù)后1 d、2 d、4 d達(dá)到增殖高峰。結(jié)論部分移植肝和肝切除后肝臟具有同樣的增殖活性,但增殖高峰POLT組及OLT組均要晚于肝切除后的肝臟,但移植組增殖周期長(zhǎng)。這可能是由于手術(shù)操作及肝臟缺血再灌注損傷所致。而持續(xù)時(shí)間長(zhǎng)可能與受體免疫系統(tǒng)產(chǎn)生的細(xì)胞因子和激素的調(diào)控相關(guān)。

引用本文: 李相成,王學(xué)浩,成峰,黃蓬. 大鼠肝移植后肝再生的實(shí)驗(yàn)研究△. 中國(guó)普外基礎(chǔ)與臨床雜志, 2002, 9(4): 228-231. doi: 復(fù)制

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  3. 3. 王學(xué)浩,張峰,李相成,等. 原位活體部分肝移植5例報(bào)告 [J]. 中華器官移植雜志, 2001; 22(5)∶285.
  4. 4. Steinbauer F, Fodra C, Muller V,et al.Partial orthotopic liver transplantation in rats [J]. Eur Surg Res,1995; 27(4)∶205.
  5. 5. Man K, Lo CM, Ng IO, et al. Liver transplantation in rats using smallforsize grafts: a study of hemodynamic and morphological changes [J]. Arch Surg, 2001; 136(3)∶280.
  6. 6. Fausto N. Liver Regeneration [J]. J Hepatol, 2000; 32(1 Suppl)∶ 19.
  7. 7. Diehl AM. Cytokine regulation of liver injury and repair [J]. Immunol Rev, 2000; 174∶160.
  8. 8. Foss A, Zoucas E, Steinbauer F, et al. Function of reducedsize liver transplant in the rat [J]. Res Exp Med (Berl), 1997; 197(2)∶91.
  9. 9. Omura T,Nakagawa T,Randall HB,et al. Increased immune responses to regenerating partial liver grafts in the rat [J]. J Surg Res,1997; 70(1)∶34.