用袖套式血管吻合法建立大鼠肝、肠联合移植模型

摘要

目的 建立肝、肠联合移植手术模型.方法 用Wistar大鼠行同种异体肝、肠联合移植.先行肝移植,再行小肠移植.肝脏为原位移植,供肠异位移植于左肾处(切除左肾).门静脉、肝下下腔静脉和肠系膜上静脉采用袖套式吻合法分别与受者的门静脉、肝下下腔静脉和左肾静脉吻合,回肠末端在左下腹造瘘.结果 手术成功率为62.5%,动物平均存活时间11.2 d.组织学检查发现移植肝和小肠发生排斥反应.结论 用袖套式血管吻合技术建立大鼠肝、肠联合移植模型是可行的.%Objectives To establish a new model of combined liver and small intestinal transplantation in rat and to probe into the action that grafted liver protect the grafted small intestine.Methods Homoplastic transplantation of combined liver and small intestine in Wistar rats was performed.The donor operation:The portal vein and superior mesenteric artery were flushed with 4℃ cold Ringer's solution. The small intestinal lumen was flushed with 4℃ cold neumycin solution.The donor small intestine and liver were taken out respectively.The recipient operation:The orthotopic liver transplantation was grafted at first.Then the small intestinal transplantation was carried out.The suprahepatic SVC was anastomosed end to end to the recipient,The donor portal vein and the inferior hepatic IVC were anastomosed by the means of the cuff method.The donor superior mesenterie artery was anastomosed end to end to the recipient left renal artery under a microscope.The donor superior mesenteric vein was anastomosed to the recipient left renal vein by means of the cuff method.The lower ileum was exteriorized as stoma in left lower abdomen.Results The successful rate of operation was 62.5%.The survival time of the grafted rats was 11.2 days.The rejection immediately occurred after operation.The grafted small intestine showed bleeding and necrosis.The grafted liver also showed rejection.Conclusion It was feasibte to establish a model of simultaneous liver and small intestine transplantation by means of cuff fashion.