• 1.四川省醫(yī)學(xué)科學(xué)院·四川省人民醫(yī)院器官移植中心(四川成都 610072);;
  • 2.攀鋼總醫(yī)院普外科(四川攀枝花 617000);

目的  建立長(zhǎng)白小家豬到恒河猴異位輔助性肝移植模型,總結(jié)手術(shù)操作要點(diǎn)。
方法  以健康雄性長(zhǎng)白小家豬和健康恒河猴各5只建立豬到猴異位輔助性肝移植模型。以長(zhǎng)白小家豬作為肝移植供體,以恒河猴作為受體。保留長(zhǎng)白小家豬的右后葉和部分右前葉作為供肝,移植到受體的左腎窩和左結(jié)腸旁溝處。短暫阻斷受體的腹主動(dòng)脈和下腔靜脈血流后,將移植肝的門(mén)靜脈和肝下下腔靜脈分別與受體的腹主動(dòng)脈和下腔靜脈行端側(cè)吻合。結(jié)扎移植肝的肝動(dòng)脈,不予重建。術(shù)后觀察受體的一般情況和生存時(shí)間。
結(jié)果  成功建立4對(duì)肝移植模型,供肝切取時(shí)間24~35min、(30±5) min,供肝修整時(shí)間31~51min、(40±10) min,受體下腔靜脈阻斷時(shí)間23~36min、(30±6) min,受體腹主動(dòng)脈阻斷時(shí)間22~38min、(30±8) min,肝移植手術(shù)時(shí)間130~310min、(220±80) min,術(shù)中失血35~48mL、(42±6) mL。術(shù)后均無(wú)吻合口血栓形成及膽漏發(fā)生。4只受體分別于術(shù)后48、54、88及96h死亡,死亡原因均為排斥反應(yīng)及術(shù)中失血過(guò)多。
結(jié)論  豬到猴異位輔助性肝移植模型的可重復(fù)性強(qiáng)、手術(shù)易操作、移植器官灌注良好,可用于豬到非人類(lèi)靈長(zhǎng)類(lèi)動(dòng)物肝移植的進(jìn)一步研究。

引用本文: 陳云飛,張恒,楊洪吉. 豬到猴異位輔助性肝移植模型的建立△. 中國(guó)普外基礎(chǔ)與臨床雜志, 2013, 20(9): 1006-1012. doi: 復(fù)制

1. Myburgh JA, Mieny CJ, Vetten B, et al. The technique of ortho-topic hepatic allotransplantation in the baboon[J]. S Afr J Surg, 1971, 9(2):81-86.
2. Platt JL, Vercellotti GM, Dalmasso AP, et al. Transplantation of discordant xenografts:a review of progress[J]. Immunol Today, 1990, 11(12):450-456.
3. Belghiti J, Sommacale D, Dondéro F, et al. Auxiliary liver transplantation for acute liver failure[J]. Liver Transpl Surg, 2004, 6(2):83-87.
4. Starzl TE, Watanabe K, Porter KA, et al. Effects of insulin, glucagon, and insuling/glucagon infusions on liver morphology and cell division after complete portacaval shunt in dogs[J]. Lancet, 1976, 1(7964):821-825.
5. Chauhan A, Lorenzen S, Herzel H, et al. Regulation of mamm-alian cell cycle progression in the regenerating liver[J]. J Theor Biol, 2011, 283(1):103-112.
6. Gui Y, Yeganeh M, Ramanathan S, et al. SOCS1 controls liver regeneration by regulating HGF signaling in hepatocytes[J]. J Hepatol, 2011, 55(6):1300-1308.
7. Tsai SM, Wang WP. Expression and function of fibroblast growth factor (FGF) 7 during liver regeneration[J]. Cell Physiol Biochem, 2011, 27(6):641-652.
8. Fan YD, Praet M, Vanzieleghem B, et al. Effects of re-arterialization on early graft function and regeneration in the rat model of heterotopic auxiliary liver transplantation[J]. Eur Surg Res, 2000, 32(1):11-17.
9. Ma Y, Wang GD, Guo ZY, et al. Surgical techniques of arteria-lized orthotopic liver transplantation in rats[J]. Chin Med J (Engl), 2007, 120(21):1914-1917.
10. 詹江華, 萬(wàn)遠(yuǎn)廉, 楊尹默, 等. 肝移植術(shù)后肝動(dòng)脈栓塞和狹窄的診治[J]. 中國(guó)現(xiàn)代醫(yī)學(xué)雜志, 2001, 11(11):19-20, 23.
11. Lange R, Rauen U, Janssen H, et al. Temporary heterotopic auxiliary liver transplantation with arterialization of the portal vein as treatment of acute liver failure[J]. Transpl Int, 2007, 20(5):473-474.
12. Shimizu Y, Miyazaki M, Shimizu H, et al. Beneficial effects of arterialization of the portal vein on extended hepatectomy[J]. Br J Surg, 2000, 87(6):784-789.
13. Schleimer K, Stippel DL, Kasper HU, et al. Auxiliary liver tran-splantation with flow-regulated portal vein arterialization offersa successful therapeutic option in acute hepatic failure—investig-ations in heterotopic auxiliary rat liver transplantation[J]. TransplInt, 2006, 19(7):581-588.
14. Schleimer K, Stippel DL, Kasper HU, et al. Portal hyperperfusion causes disturbance of microcirculation and increased rate of hepatocellular apoptosis:investigations in heterotopic rat liver transplantation with portal vein arterialization[J]. Transplant Proc, 2006, 38(3):725-729.
15. Fernández-Rodríguez OM, Palenciano CG, Ríos A, et al. Hemodynamic assessment during auxiliary heterotopic liver transplantation with portal vein arterialization in a Swine model:preliminary report of 10 transplants[J]. Transplant Proc, 2006, 38(8):2603-2605.
16. Terpstra OT, Schalm SW, Weimar W, et al. Auxiliary partial liver transplantation for end-stage chronic liver disease[J]. N Engl J Med, 1988, 319(23):1507-1511.
17. Wang YN, Ng IO, To J, et al. A modified method of auxiliary partial liver transplantation in the rat[J]. Hepatogastroenterology,.
18. Jiang M, Han D. Auxiliary liver-heart transplantation in the rat:a new microsurgical model inducing tolerance[J]. Transplant Proc, 2004, 36(5):1607-1609.
19. Bach FH, Robson SC, Winkler H, et al. Barriers to xenotransplantation[J]. Nat Med, 1995, 1(9):869-873.
20. Auchincloss H Jr, Sachs DH. Xenogeneic transplantation[J]. Annu Rev Immunol, 1998, 16:433-470.
21. Samstein B, Platt JL. Physiologic and immunologic hurdles to xenotransplantation[J]. J Am Soc Nephrol, 2001, 12(1):182-193.
22. Ramirez P, Chavez R, Majado M, et al. Study of xenograft reje-ction in a model of liver xetransplantation from unmodi?ed pig to primate[J]. Transplant Proc, 1999, 31(7):2814-2817.
23. Calne RY, Davids DR, Pena JR, et al. Hepatic allografts and xenografts in primates[J]. Lancet, 1970, 1(7638):103-106.
24. Luo Y, Kosanke S, Mieles L, et al. Comparative histopathology of hepatic allografts and xenografts in the nonhuman primate[J]. Xenotransplantation, 1998, 5(3):197-206.
25. Shimizu A, Hisashi Y, Kuwaki K, et al. Thrombotic microangiopathy associated with humoral rejection of cardiac xenografts from alpha1, 3-galactosyltransferase gene-knockout pigs in baboons[J]. Am J Pathol, 2008, 172(6):1471-1481.
26. , 46(25):428-431.
  1. 1. Myburgh JA, Mieny CJ, Vetten B, et al. The technique of ortho-topic hepatic allotransplantation in the baboon[J]. S Afr J Surg, 1971, 9(2):81-86.
  2. 2. Platt JL, Vercellotti GM, Dalmasso AP, et al. Transplantation of discordant xenografts:a review of progress[J]. Immunol Today, 1990, 11(12):450-456.
  3. 3. Belghiti J, Sommacale D, Dondéro F, et al. Auxiliary liver transplantation for acute liver failure[J]. Liver Transpl Surg, 2004, 6(2):83-87.
  4. 4. Starzl TE, Watanabe K, Porter KA, et al. Effects of insulin, glucagon, and insuling/glucagon infusions on liver morphology and cell division after complete portacaval shunt in dogs[J]. Lancet, 1976, 1(7964):821-825.
  5. 5. Chauhan A, Lorenzen S, Herzel H, et al. Regulation of mamm-alian cell cycle progression in the regenerating liver[J]. J Theor Biol, 2011, 283(1):103-112.
  6. 6. Gui Y, Yeganeh M, Ramanathan S, et al. SOCS1 controls liver regeneration by regulating HGF signaling in hepatocytes[J]. J Hepatol, 2011, 55(6):1300-1308.
  7. 7. Tsai SM, Wang WP. Expression and function of fibroblast growth factor (FGF) 7 during liver regeneration[J]. Cell Physiol Biochem, 2011, 27(6):641-652.
  8. 8. Fan YD, Praet M, Vanzieleghem B, et al. Effects of re-arterialization on early graft function and regeneration in the rat model of heterotopic auxiliary liver transplantation[J]. Eur Surg Res, 2000, 32(1):11-17.
  9. 9. Ma Y, Wang GD, Guo ZY, et al. Surgical techniques of arteria-lized orthotopic liver transplantation in rats[J]. Chin Med J (Engl), 2007, 120(21):1914-1917.
  10. 10. 詹江華, 萬(wàn)遠(yuǎn)廉, 楊尹默, 等. 肝移植術(shù)后肝動(dòng)脈栓塞和狹窄的診治[J]. 中國(guó)現(xiàn)代醫(yī)學(xué)雜志, 2001, 11(11):19-20, 23.
  11. 11. Lange R, Rauen U, Janssen H, et al. Temporary heterotopic auxiliary liver transplantation with arterialization of the portal vein as treatment of acute liver failure[J]. Transpl Int, 2007, 20(5):473-474.
  12. 12. Shimizu Y, Miyazaki M, Shimizu H, et al. Beneficial effects of arterialization of the portal vein on extended hepatectomy[J]. Br J Surg, 2000, 87(6):784-789.
  13. 13. Schleimer K, Stippel DL, Kasper HU, et al. Auxiliary liver tran-splantation with flow-regulated portal vein arterialization offersa successful therapeutic option in acute hepatic failure—investig-ations in heterotopic auxiliary rat liver transplantation[J]. TransplInt, 2006, 19(7):581-588.
  14. 14. Schleimer K, Stippel DL, Kasper HU, et al. Portal hyperperfusion causes disturbance of microcirculation and increased rate of hepatocellular apoptosis:investigations in heterotopic rat liver transplantation with portal vein arterialization[J]. Transplant Proc, 2006, 38(3):725-729.
  15. 15. Fernández-Rodríguez OM, Palenciano CG, Ríos A, et al. Hemodynamic assessment during auxiliary heterotopic liver transplantation with portal vein arterialization in a Swine model:preliminary report of 10 transplants[J]. Transplant Proc, 2006, 38(8):2603-2605.
  16. 16. Terpstra OT, Schalm SW, Weimar W, et al. Auxiliary partial liver transplantation for end-stage chronic liver disease[J]. N Engl J Med, 1988, 319(23):1507-1511.
  17. 17. Wang YN, Ng IO, To J, et al. A modified method of auxiliary partial liver transplantation in the rat[J]. Hepatogastroenterology,.
  18. 18. Jiang M, Han D. Auxiliary liver-heart transplantation in the rat:a new microsurgical model inducing tolerance[J]. Transplant Proc, 2004, 36(5):1607-1609.
  19. 19. Bach FH, Robson SC, Winkler H, et al. Barriers to xenotransplantation[J]. Nat Med, 1995, 1(9):869-873.
  20. 20. Auchincloss H Jr, Sachs DH. Xenogeneic transplantation[J]. Annu Rev Immunol, 1998, 16:433-470.
  21. 21. Samstein B, Platt JL. Physiologic and immunologic hurdles to xenotransplantation[J]. J Am Soc Nephrol, 2001, 12(1):182-193.
  22. 22. Ramirez P, Chavez R, Majado M, et al. Study of xenograft reje-ction in a model of liver xetransplantation from unmodi?ed pig to primate[J]. Transplant Proc, 1999, 31(7):2814-2817.
  23. 23. Calne RY, Davids DR, Pena JR, et al. Hepatic allografts and xenografts in primates[J]. Lancet, 1970, 1(7638):103-106.
  24. 24. Luo Y, Kosanke S, Mieles L, et al. Comparative histopathology of hepatic allografts and xenografts in the nonhuman primate[J]. Xenotransplantation, 1998, 5(3):197-206.
  25. 25. Shimizu A, Hisashi Y, Kuwaki K, et al. Thrombotic microangiopathy associated with humoral rejection of cardiac xenografts from alpha1, 3-galactosyltransferase gene-knockout pigs in baboons[J]. Am J Pathol, 2008, 172(6):1471-1481.
  26. 26. , 46(25):428-431.
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