目的 建立長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。
方法 以健康雄性長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。以長白小家豬作為肝移植供體,以恒河猴作為受體。保留長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脈和下腔靜脈血流后,將移植肝的門靜脈和肝下下腔靜脈分別與受體的腹主動脈和下腔靜脈行端側(cè)吻合。結(jié)扎移植肝的肝動脈,不予重建。術(shù)后觀察受體的一般情況和生存時間。
結(jié)果 成功建立4對肝移植模型,供肝切取時間24~35min、(30±5) min,供肝修整時間31~51min、(40±10) min,受體下腔靜脈阻斷時間23~36min、(30±6) min,受體腹主動脈阻斷時間22~38min、(30±8) min,肝移植手術(shù)時間130~310min、(220±80) min,術(shù)中失血35~48mL、(42±6) mL。術(shù)后均無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)中失血過多。
結(jié)論 豬到猴異位輔助性肝移植模型的可重復(fù)性強、手術(shù)易操作、移植器官灌注良好,可用于豬到非人類靈長類動物肝移植的進一步研究。
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△. 中國普外基礎(chǔ)與臨床雜志, 2013, 20(9): 1006-1012. doi: 復(fù)制
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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. |
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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, 萬遠廉, 楊尹默, 等. 肝移植術(shù)后肝動脈栓塞和狹窄的診治[J]. 中國現(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. 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, 萬遠廉, 楊尹默, 等. 肝移植術(shù)后肝動脈栓塞和狹窄的診治[J]. 中國現(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.