• 昆明市第一人民醫(yī)院暨昆明醫(yī)學(xué)院附屬甘美醫(yī)院肝膽胰一科、云南省器官移植研究所肝移植研究中心（昆明 650011）;

目的 探討恒河猴原位肝移植模型建立的最佳方案。
方法 選用10對(duì)健康恒河猴進(jìn)行同種異體肝移植，借鑒各種動(dòng)物模型建立的方法，使用門靜脈袖套法建立穩(wěn)定的恒河猴原位肝移植模型。
結(jié)果 10只恒河猴原位肝移植模型手術(shù)均成功。供體切取手術(shù)時(shí)間(20±5) min，供肝修整時(shí)間(30±7) min； 受體手術(shù)時(shí)間(180±35) min,受體無肝期(17±4) min。術(shù)后24 h存活者9只,1只術(shù)后9 h死于腹腔內(nèi)出血; 72 h存活者8只，于術(shù)后38 h因消化道出血再死亡1只; 1周存活5只,3只分別于術(shù)后9、11和11 d死于排斥反應(yīng)； 最長存活32 d者也死于排斥反應(yīng)。所有受體均無門靜脈血栓形成及膽道并發(fā)癥發(fā)生。
結(jié)論 改進(jìn)后的恒河猴同種異體原位肝移植模型具有操作簡便、手術(shù)成功率高的優(yōu)點(diǎn), 是肝移植臨床前期研究較理想的動(dòng)物模型。

引用本文： 冉江華,張升寧,劉靜,李鑄,李來邦,吳淑媛,李立. 恒河猴同種異體原位肝移模型的改進(jìn). 中國普外基礎(chǔ)與臨床雜志, 2010, 17(7): 694-698. doi: 復(fù)制

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1. Nakano T, Lai CY, Goto S, et al. Significance of portosystemic shunt on graft survival in liver transplantation: a rat model [J]. Transplant Proc, 2008; 40(8): 25152516.
2. Shi Y, Lv Y, Wang B, et al. Novel magnetic rings for rapid vascular reconstruction in canine liver transplantation model [J]. Transplant Proc, 2006; 38(9): 30703074.
3. Wang HS, Ohkohchi N, Enomoto Y, et al. Excessive portal flow causes graft failure in extremely smallforsize liver transplantation in pigs [J]. World J Gastroenterol, 2005; 11(44): 69546959.
4. Vekemans K, Liu Q, Heedfeld V, et al. Hypothermic liver machine perfusion with EKPS1 solution vs aqix RSI solution: in vivo feasibility study in a pig transplantation model [J]. Transplant Proc, 2009; 41(2): 617621.
5. Myburgh JA, Mieny CJ, Vetten B, et al. The technique of orthotopic hepatic allotransplantation in the baboon [J]. S Afr J Surg, 1971; 9(2): 8186.
6. Peng Y, Gong JP, Yan LN, et al. Improved twocuff technique for orthotopic liver transplantation in rat [J]. Hepatobiliary Pancreat Dis Int, 2004; 3(1): 3337.
7. Matevossian E, Doll D, Hüser N, et al. Liver transplantation in the rat: singlecenter experience with technique, longterm survival, and functional and histologic findings [J]. Transplant Proc, 2009; 41(6): 26312636.
8. Hoffmann K, Weigand MA, Hillebrand N, et al. Is venovenous bypass still needed during liver transplantation? A review of the literature [J]. Clin Transplant, 2009; 23(1): 18.
9. Wojcicki M, Jarosz K, Czuprynska M, et al. Liver transplantation for fulminant hepatic failure without venovenous bypass and without portacaval shunting [J]. Transplant Proc, 2006; 38(1): 215218.
10. Witkowski K, Piecuch J. Liver transplant without a venovenous bypass [J]. Ann Transplant, 2001; 6(1):1617.
11. Arcari M, Phillips SD, Gibbs P, et al. An investigation into the risk of air embolus during venovenous bypass in orthotopic liver transplantation [J]. Transplantation, 1999; 68(1): 150152.
12. Viana JS, Furtado E, Romero A, et al. Air embolism as a complication of venovenous bypass during liver transplant for diffuse hemangiomatosis [J]. Transplant Proc, 2003; 35(3): 11281130.
13. Neelakanta G, Csete M, Busuttil RW. Arteriovenous obstruction of arm due to venovenous bypass during liver transplantation [J]. J Clin Anesth, 1997; 9(6): 507509.
14. Currin RT, Relnstein LJ, Lichtman SN, et al. Inhibition of tumor necrosis factor release from cultured rat Kupffer cells by agents that reduce graft failure from storage injury [J]. Transplant proc, 1993; 25(1 Pt 2): 16311632.
15. Ijtsma AJ, van der Hilst CS, de Boer MT, et al. The clinical relevance of the anhepatic phase during liver transplantation [J]. Liver Transpl, 2009; 15(9): 10501055.
16. Khosravi MB, Jalaeian H, Lahsaee MT, et al. The effect of clamping of inferior vena cava and portal vein on urine output during liver transplantation [J]. Transplant Proc, 2007; 39(4): 11971198.
17. 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297.
18. Yokota K, Uchida H, Satoh K, et al. Orthotopic liver transplantation in dogs - using a cuff technique for vascular anastomoses, with special reference to long term survival dogs treated with mizorbine [J]. Jpn J Transplant, 1987; 22(1): 814.
19. Liu C, Tsai HL, Chin T, et al. Clamping the supraceliac aorta can effectively increase the success rate of orthotopic rat liver transplantation by increasing the tolerable time of the anhepatic phase [J]. J Surg Res, 2006; 136(1):116119.
20. MoorJankowski J, Wiener AS, Rogers CM. Human blood group factors in nonhuman primates [J]. Nature, 1964; 202: 663665.
21. Ariyakhagorn V, Schmitz V, Olschewski P, et al. Improvement of microsurgical techniques in orthotopic rat liver transplantation [J]. J Surg Res, 2009; 153(2): 332339.
22. 張升寧, 李立, 冉江華, 等. 原位肝移植術(shù)中動(dòng)脈重建及術(shù)后并發(fā)癥的防治 [J]. 中國普外基礎(chǔ)與臨床雜志, 2007; 14(5): 564568.
23. 張升寧, 李立, 冉江華, 等. 活體肝移植中肝動(dòng)脈的處理 [J]. 國際外科雜志, 2008; 35(2): 9295.
24. 冉江華, 張升寧, 李鑄, 等. 肝動(dòng)脈腹主動(dòng)脈搭橋在原位肝移植術(shù)中的應(yīng)用 [J]. 中國普外基礎(chǔ)與臨床雜志, 2008; 15(2): 102105.
  1. 1. Nakano T, Lai CY, Goto S, et al. Significance of portosystemic shunt on graft survival in liver transplantation: a rat model [J]. Transplant Proc, 2008; 40(8): 25152516.
  2. 2. Shi Y, Lv Y, Wang B, et al. Novel magnetic rings for rapid vascular reconstruction in canine liver transplantation model [J]. Transplant Proc, 2006; 38(9): 30703074.
  3. 3. Wang HS, Ohkohchi N, Enomoto Y, et al. Excessive portal flow causes graft failure in extremely smallforsize liver transplantation in pigs [J]. World J Gastroenterol, 2005; 11(44): 69546959.
  4. 4. Vekemans K, Liu Q, Heedfeld V, et al. Hypothermic liver machine perfusion with EKPS1 solution vs aqix RSI solution: in vivo feasibility study in a pig transplantation model [J]. Transplant Proc, 2009; 41(2): 617621.
  5. 5. Myburgh JA, Mieny CJ, Vetten B, et al. The technique of orthotopic hepatic allotransplantation in the baboon [J]. S Afr J Surg, 1971; 9(2): 8186.
  6. 6. Peng Y, Gong JP, Yan LN, et al. Improved twocuff technique for orthotopic liver transplantation in rat [J]. Hepatobiliary Pancreat Dis Int, 2004; 3(1): 3337.
  7. 7. Matevossian E, Doll D, Hüser N, et al. Liver transplantation in the rat: singlecenter experience with technique, longterm survival, and functional and histologic findings [J]. Transplant Proc, 2009; 41(6): 26312636.
  8. 8. Hoffmann K, Weigand MA, Hillebrand N, et al. Is venovenous bypass still needed during liver transplantation? A review of the literature [J]. Clin Transplant, 2009; 23(1): 18.
  9. 9. Wojcicki M, Jarosz K, Czuprynska M, et al. Liver transplantation for fulminant hepatic failure without venovenous bypass and without portacaval shunting [J]. Transplant Proc, 2006; 38(1): 215218.
  10. 10. Witkowski K, Piecuch J. Liver transplant without a venovenous bypass [J]. Ann Transplant, 2001; 6(1):1617.
  11. 11. Arcari M, Phillips SD, Gibbs P, et al. An investigation into the risk of air embolus during venovenous bypass in orthotopic liver transplantation [J]. Transplantation, 1999; 68(1): 150152.
  12. 12. Viana JS, Furtado E, Romero A, et al. Air embolism as a complication of venovenous bypass during liver transplant for diffuse hemangiomatosis [J]. Transplant Proc, 2003; 35(3): 11281130.
  13. 13. Neelakanta G, Csete M, Busuttil RW. Arteriovenous obstruction of arm due to venovenous bypass during liver transplantation [J]. J Clin Anesth, 1997; 9(6): 507509.
  14. 14. Currin RT, Relnstein LJ, Lichtman SN, et al. Inhibition of tumor necrosis factor release from cultured rat Kupffer cells by agents that reduce graft failure from storage injury [J]. Transplant proc, 1993; 25(1 Pt 2): 16311632.
  15. 15. Ijtsma AJ, van der Hilst CS, de Boer MT, et al. The clinical relevance of the anhepatic phase during liver transplantation [J]. Liver Transpl, 2009; 15(9): 10501055.
  16. 16. Khosravi MB, Jalaeian H, Lahsaee MT, et al. The effect of clamping of inferior vena cava and portal vein on urine output during liver transplantation [J]. Transplant Proc, 2007; 39(4): 11971198.
  17. 17. 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297.
  18. 18. Yokota K, Uchida H, Satoh K, et al. Orthotopic liver transplantation in dogs - using a cuff technique for vascular anastomoses, with special reference to long term survival dogs treated with mizorbine [J]. Jpn J Transplant, 1987; 22(1): 814.
  19. 19. Liu C, Tsai HL, Chin T, et al. Clamping the supraceliac aorta can effectively increase the success rate of orthotopic rat liver transplantation by increasing the tolerable time of the anhepatic phase [J]. J Surg Res, 2006; 136(1):116119.
  20. 20. MoorJankowski J, Wiener AS, Rogers CM. Human blood group factors in nonhuman primates [J]. Nature, 1964; 202: 663665.
  21. 21. Ariyakhagorn V, Schmitz V, Olschewski P, et al. Improvement of microsurgical techniques in orthotopic rat liver transplantation [J]. J Surg Res, 2009; 153(2): 332339.
  22. 22. 張升寧, 李立, 冉江華, 等. 原位肝移植術(shù)中動(dòng)脈重建及術(shù)后并發(fā)癥的防治 [J]. 中國普外基礎(chǔ)與臨床雜志, 2007; 14(5): 564568.
  23. 23. 張升寧, 李立, 冉江華, 等. 活體肝移植中肝動(dòng)脈的處理 [J]. 國際外科雜志, 2008; 35(2): 9295.
  24. 24. 冉江華, 張升寧, 李鑄, 等. 肝動(dòng)脈腹主動(dòng)脈搭橋在原位肝移植術(shù)中的應(yīng)用 [J]. 中國普外基礎(chǔ)與臨床雜志, 2008; 15(2): 102105.