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单人直视下大鼠肝移植模型供肝获取不同灌注方式比较

李蕾 李善宝 汪涛 沃琪 曹婉悦 徐军明

李蕾, 李善宝, 汪涛, 等. 单人直视下大鼠肝移植模型供肝获取不同灌注方式比较[J]. 器官移植, 2020, 11(3): 356-361. doi: 10.3969/j.issn.1674-7445.2020.03.006
引用本文: 李蕾, 李善宝, 汪涛, 等. 单人直视下大鼠肝移植模型供肝获取不同灌注方式比较[J]. 器官移植, 2020, 11(3): 356-361. doi: 10.3969/j.issn.1674-7445.2020.03.006
Li Lei, Li Shanbao, Wang Tao, et al. Comparison between different perfusion methods for donor liver acquisition in rat liver transplantation model under direct vision of single operator[J]. ORGAN TRANSPLANTATION, 2020, 11(3): 356-361. doi: 10.3969/j.issn.1674-7445.2020.03.006
Citation: Li Lei, Li Shanbao, Wang Tao, et al. Comparison between different perfusion methods for donor liver acquisition in rat liver transplantation model under direct vision of single operator[J]. ORGAN TRANSPLANTATION, 2020, 11(3): 356-361. doi: 10.3969/j.issn.1674-7445.2020.03.006

单人直视下大鼠肝移植模型供肝获取不同灌注方式比较

doi: 10.3969/j.issn.1674-7445.2020.03.006
基金项目: 

国家自然科学基金面上项目 81600595

国家自然科学基金面上项目 81970568

详细信息
    作者简介:

    李蕾,女,1995年生,硕士研究生,研究方向为外科学,Email:LiLei950214@sjtu.edu.cn

    通讯作者:

    徐军明,男,1971年生,博士研究生导师,教授,研究方向为肝移植免疫,Email:xjmsh@163.com

  • 中图分类号: R617

Comparison between different perfusion methods for donor liver acquisition in rat liver transplantation model under direct vision of single operator

More Information
  • 摘要:   目的  单人直视下建立大鼠肝移植模型,并探讨不同灌注方法对供肝质量的影响。  方法  在Kamada建立的“二袖套法”基础上改进手术细节,建立大鼠肝移植模型。根据不同的灌注方式将受体大鼠分为A(经腹主动脉灌注)、B(经门静脉灌注)两组。比较两组的灌注效果、手术时间、手术成功率、术后肝功能、肝脏移植物病理学表现及生存情况等。  结果  灌注完成后,B组肝血窦内残留红细胞较A组多。A组在供肝灌注时间及供体手术时间上均较B组时间长,差异均有统计学意义(均为P < 0.01)。A、B两组手术成功率分别为77%和71%。大鼠肝移植术后3d,两组受体丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TB)水平均较正常值明显升高;术后7、30 d,与A组比较,B组ALT、AST、TB水平均明显升高,差异均有统计学意义(均为P < 0.01~0.05)。肝脏病理学检查提示B组肝脏炎症反应程度及肝组织破坏程度均较A组严重,但两组的术后长期生存率差异无统计学意义。  结论  经腹主动脉灌注大鼠肝移植模型虽稍延长了灌注时间及供体手术时间,但灌注效果更佳,可减轻术后肝组织损伤,使肝功能更快地恢复正常水平。

     

  • 图  1  两组大鼠供肝灌注效果比较(HE)

    注:A、B图示A组大鼠供肝;C、D图示B组大鼠供肝。

    Figure  1.  Comparison of the donor liver perfusion effect of rats between two groups

    图  2  两组大鼠肝移植术后肝脏移植物的病理学表现(HE)

    Figure  2.  Pathological manifestations of liver grafts of rats in two groups after liver transplantation

    表  1  大鼠肝移植各步骤操作时间

    Table  1.   Operation time of each procedure in rat liver transplantation(x±s, min)

    组别 n 肝脏灌注时间 供体手术时间 冷保存时间 无肝期 受体手术时间
    A组 20 4.7±0.4 36±4 70±14 20.6±2.1 69±8
    B组 20 2.9±0.3 33±4 72±9 20.6±1.8 71±8
    P   < 0.001 < 0.01 > 0.05 > 0.05 > 0.05
    下载: 导出CSV

    表  2  两组受体大鼠肝移植术后ALT、AST、TB水平的比较

    Table  2.   Comparison of the ALT、AST and TB levels of recipient rats after liver transplantation

    组别nALT(x±s, U/L)AST(x±s, U/L)TB[M(Q25, Q75), μmol/L]
    3d7d30d3d7d30d3d7d30d
    A组5337±8059±584±19788±63181±36388±1763.0(2.0,3.8)1.7(0.5,2.7)6.4(3.3,12.8)
    B组5427±182234±155171±54950±320809±4001 122±10611.1(6.9,39.0)50.1(25.3,74.0)70.0(23.7,82.3)
    P>0.050.040.01>0.050.04<0.010.030.010.02
    下载: 导出CSV
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出版历程
  • 收稿日期:  2020-01-19
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2020-05-15

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