大鼠40%小體積肝移植肝動脈重建的意義_《中國普外基礎與臨床雜志》

作者：

徐貴云 ¹ , 江藝 ² , 陳海燕 ³ , 潘凡 ²

1.淮安市第二人民醫院普外科(江蘇淮安223002);;
2.全軍器官移植中心，福州總醫院南京軍區肝膽外科研究所(福州350025);;
3.淮安市第二人民醫院檢驗科(江蘇淮安223002);

關鍵詞：

小體積肝移植肝移植模型肝動脈重建移植肝

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目的　探討肝動脈重建在大鼠小體積肝移植中的意義。
方法　采用改良二袖套法建立大鼠40%小體積肝移植模型，實驗分重建動脈組和未重建動脈組，觀察1周生存率，并于術后1、2、4及7 d檢測肝功能、觀察移植肝組織學變化以及免疫組化法檢測肝細胞增殖細胞核抗原（PCNA）的表達。
結果　重建動脈組1周生存率為65.0%（13/20），未重建動脈組1周生存率為50.0%（10/20），2組比較差異無統計學意義(P gt;0.05)。2組ALT和TB于術后第1天即開始明顯升高，第2天達高峰，以后逐漸降低; 重建動脈組TB于第2、7天低于未重建動脈組，ALT于第2、4天低于未重建動脈組，差異均有統計學意義（P＜0.05）。重建動脈組術后中央靜脈及肝竇擴張程度較未重建動脈組相對較輕，可見較多二倍體和多倍體肝細胞; 2組大鼠移植肝的肝細胞中PCNA表達均于術后第2天達高峰，重建動脈組術后第1天的PCNA表達陽性率高于未重建動脈組（P＜0.01），而術后第7天則低于未重建動脈組，差異有統計學意義（P＜0.05）。
結論　肝動脈重建可明顯改善大鼠小體積移植肝的功能，促進移植肝的再生，有效地保護移植肝的組織學結構，重建動脈組術后早期肝細胞增殖較未重建動脈組活躍。

引用本文： 徐貴云,江藝,陳海燕,潘凡. 大鼠40%小體積肝移植肝動脈重建的意義. 中國普外基礎與臨床雜志, 2009, 16(9): 718-722. doi: 復制

1.	Heaton N. Small-for-size liver syndrome after auxiliary and split liver transplantation: donor selection [Ｊ]. Liver Transpl, 2003; 9(9): S26-S28.
2.	Lo CM, Fan ST, Liu CL, et al. Imum graft size for successful living donor liver transplantation [Ｊ]. Transplantation, 1999; 68(8): 1112-1116.
3.	徐貴云，江藝，陳海燕，等. 大鼠40%小體積肝移植模型建立及移植肝的病理觀察 [Ｊ]. 肝膽外科雜志, 2008; 16(6): 454-457.
4.	Kamada N, Calne RY. Orthotopic liver transplantation in the rat. Technique using cuff for portal vein anastomosis and biliary drainage [Ｊ]. Transplantation, 1979; 28(1): 47-50.
5.	徐貴云，江藝，陳海燕，等. 大鼠40%小體積肝移植動脈化模型建立及移植肝的病理觀察 [Ｊ]. 中國普外基礎與臨床雜志， 2009; 16(3): 180-183.
6.	Knoop M, Bachmann S, Keck H, et al. Experience with cuff rearterialization in 600 orthotopic liver grafts in the rat [Ｊ]. Am J Surg, 1994; 167(3): 360-363.
7.	Li J, Dahmen U, Dirsch O, et al. Modified sleeve anastomosis for reconstruction of the hepatic artery in rat liver transplantation [Ｊ]. Microsurgery, 2002; 22(2): 62-68.
8.	黃新立, 張峰, 王學浩, 等. 建立大鼠部分肝移植動脈化模型的實驗研究 [Ｊ]. 中國普外基礎與臨床雜志, 2004; 11(3)： 224-227.
9.	Gao W, Lemasters JJ, Thurman RG. Development of a new method for hepatic rearterialization in rat orthotopic liver transplantation. Reduction of liver injury and improvement of surgical outcome by arterialization [Ｊ]. Transplantation,1993; 56(1): 19-24.
10.	Reck T, Steinbauer F, Steinbauer M, et al. Impact of arterialization on hepatic oxygen supply, tissue energy phosphates, and outcome after liver transplantation in the rat [Ｊ]. Transplantation, 1996; 62(5): 582-587.
11.	Xu HS, Pruett TL, Jones RS. Study of donor-recipient liver size match for transplantation [Ｊ]. Ann Surg, 1994; 219(1): 46-50.
12.	Man K, Fan ST, Lo CM, et al. Graft injury in relation to graft size in right lobe live donor liver transplantation: a study of hepatic sinusoidal injury in correlation with portal hemodynamics and intragraft gene expression [Ｊ]. Ann Surg, 2003; 237(2): 256-264.
13.	Miki C, Iriyama K, Strain A, et al.Clinical significance of serum hepatocyte growth factor in orthotopic liver transplantation [Ｊ]. Surgery, 1996; 119(5): 505-510.
14.	Galand P, Degraef C. Cyclin/PCNA immunostaining as an al-ternative to tritiated thymidine pulse labelling for marking S phase cells in paraffin sections from animal and human tissues [Ｊ]. Cell Tissue Kinet, 1989; 22(5): 383-392.
15.	Fausto N. Liver regeneration [Ｊ]. J Hepatol, 2000; 32(1 Suppl): 19-31.

1. Heaton N. Small-for-size liver syndrome after auxiliary and split liver transplantation: donor selection [Ｊ]. Liver Transpl, 2003; 9(9): S26-S28.
2. Lo CM, Fan ST, Liu CL, et al. Imum graft size for successful living donor liver transplantation [Ｊ]. Transplantation, 1999; 68(8): 1112-1116.
3. 徐貴云，江藝，陳海燕，等. 大鼠40%小體積肝移植模型建立及移植肝的病理觀察 [Ｊ]. 肝膽外科雜志, 2008; 16(6): 454-457.
4. Kamada N, Calne RY. Orthotopic liver transplantation in the rat. Technique using cuff for portal vein anastomosis and biliary drainage [Ｊ]. Transplantation, 1979; 28(1): 47-50.
5. 徐貴云，江藝，陳海燕，等. 大鼠40%小體積肝移植動脈化模型建立及移植肝的病理觀察 [Ｊ]. 中國普外基礎與臨床雜志， 2009; 16(3): 180-183.
6. Knoop M, Bachmann S, Keck H, et al. Experience with cuff rearterialization in 600 orthotopic liver grafts in the rat [Ｊ]. Am J Surg, 1994; 167(3): 360-363.
7. Li J, Dahmen U, Dirsch O, et al. Modified sleeve anastomosis for reconstruction of the hepatic artery in rat liver transplantation [Ｊ]. Microsurgery, 2002; 22(2): 62-68.
8. 黃新立, 張峰, 王學浩, 等. 建立大鼠部分肝移植動脈化模型的實驗研究 [Ｊ]. 中國普外基礎與臨床雜志, 2004; 11(3)： 224-227.
9. Gao W, Lemasters JJ, Thurman RG. Development of a new method for hepatic rearterialization in rat orthotopic liver transplantation. Reduction of liver injury and improvement of surgical outcome by arterialization [Ｊ]. Transplantation,1993; 56(1): 19-24.
10. Reck T, Steinbauer F, Steinbauer M, et al. Impact of arterialization on hepatic oxygen supply, tissue energy phosphates, and outcome after liver transplantation in the rat [Ｊ]. Transplantation, 1996; 62(5): 582-587.
11. Xu HS, Pruett TL, Jones RS. Study of donor-recipient liver size match for transplantation [Ｊ]. Ann Surg, 1994; 219(1): 46-50.
12. Man K, Fan ST, Lo CM, et al. Graft injury in relation to graft size in right lobe live donor liver transplantation: a study of hepatic sinusoidal injury in correlation with portal hemodynamics and intragraft gene expression [Ｊ]. Ann Surg, 2003; 237(2): 256-264.
13. Miki C, Iriyama K, Strain A, et al.Clinical significance of serum hepatocyte growth factor in orthotopic liver transplantation [Ｊ]. Surgery, 1996; 119(5): 505-510.
14. Galand P, Degraef C. Cyclin/PCNA immunostaining as an al-ternative to tritiated thymidine pulse labelling for marking S phase cells in paraffin sections from animal and human tissues [Ｊ]. Cell Tissue Kinet, 1989; 22(5): 383-392.
15. Fausto N. Liver regeneration [Ｊ]. J Hepatol, 2000; 32(1 Suppl): 19-31.

《中國普外基礎與臨床雜志》

大鼠40%小體積肝移植肝動脈重建的意義

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《中國普外基礎與臨床雜志》

大鼠40%小體積肝移植肝動脈重建的意義

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

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