• 第三軍醫(yī)大學(xué)西南醫(yī)院全軍肝膽外科研究所(重慶400038);;
  • 通訊作者: 董家鴻;

【摘要】目的 建立標(biāo)準(zhǔn)化程度高、重復(fù)性和穩(wěn)定性好的小型豬原位肝移植模型。
方法 選巴馬小型豬為實驗動物,在非體外靜脈轉(zhuǎn)流條件下行同種異體原位肝移植術(shù),觀察動物存活率及術(shù)中血流動力學(xué)、血?dú)夂蜕笜?biāo)的改變。
結(jié)果 在非體外靜脈轉(zhuǎn)流條件下行同種異體原位肝移植20例,平均手術(shù)時間為(181±25.8) min,平均無肝期(28.4±3.2) min。在無肝期,血流動力學(xué)和代謝發(fā)生急劇變化: 平均動脈壓(MAP)從無肝前期的(14.59±1.68) kPa(1 cm H2O=0.098 kPa)降至(5.87±0.91) kPa,中心靜脈壓(CVP)從(0.66±0.11 ) kPa降至(0.27±0.10) kPa; 體溫、pH、剩余堿(BE)及HCO3ˉ顯著降低,心率及血清K+顯著升高(P<0.05); 隨著門靜脈和下腔靜脈血流的開放,血流動力學(xué)及代謝紊亂即逐漸恢復(fù)正常。動物1周存活率為90%,16頭動物存活2周以上。肝功結(jié)果: 術(shù)后第1天ALT、AST和TBIL顯著升高并達(dá)到峰值,第2天開始下降,第7天降至麻醉后水平。
結(jié)論 非轉(zhuǎn)流條件下的小型豬同種異體原位肝移植模型具有標(biāo)準(zhǔn)化程度及手術(shù)成功率高、重復(fù)性和穩(wěn)定性好的優(yōu)點,是大型動物肝移植系列研究的理想動物模型。

引用本文: 鄭樹國,馮曉彬 董家鴻,冷建軍,李昆,鄭平,熊燕,張玉君. 非轉(zhuǎn)流小型豬原位肝移植模型的建立及評價. 中國普外基礎(chǔ)與臨床雜志, 2005, 12(5): 451-454. doi: 復(fù)制

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  3. 3. Laino GM, Anastasi A, Fabbri LP, et al. Experimental liver transplantation in pigs. Surgical technique and complications [J]. Minerva Chir, 1996; 51(10)∶765.
  4. 4. Oike F, Uryuhara K, Otsuka M, et al. Simplified technique of orthotopic liver transplantation in pigs [J]. Transplantation, 2001; 71(2)∶328.
  5. 5. Oldhafer KJ, Hauss J, Gubernatis G, et al. Liver transplantation in pigs: a model for studying reperfusion injury [J]. J Invest Surg, 1993; 6(5)∶439.
  6. 6. Monden M, Barter RH, Fortner JG, et al. A simple method of orthotopic liver transplantation in dogs [J]. Ann Surg, 1982; 195(1)∶110.
  7. 7. Tanaka K, Nishimura A, Ogata S, et al. A simple method for orthotopic liver transplantation in pigs——a new cuff technique using expanded polytetrafluoroethylene vascular grafts for portal and vena caval anastomosis [J]. Transplantation, 1994; 58(10)∶1139.
  8. 8. Fukumoto T, Ku Y, Tominaga M, et al. A novel paper cuff for vascular reconstruction in canine liver transplantation [J]. Surg Today, 1996; 26(4)∶295.