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目的建立长白小家猪到恒河猴异位辅助性肝移植模型,总结手术操作要点。方法以健康雄性长白小家猪和健康恒河猴各5只建立猪到猴异位辅助性肝移植模型。以长白小家猪作为肝移植供体,以恒河猴作为受体。保留长白小家猪的右后叶和部分右前叶作为供肝,移植到受体的左肾窝和左结肠旁沟处。短暂阻断受体的腹主动脉和下腔静脉血流后,将移植肝的门静脉和肝下下腔静脉分别与受体的腹主动脉和下腔静脉行端侧吻合。结扎移植肝的肝动脉,不予重建。术后观察受体的一般情况和生存时间。结果成功建立4对肝移植模型,供肝切取时间24~35 min(、30±5)min,供肝修整时间31~51 min(、40±10)min,受体下腔静脉阻断时间23~36 min、(30±6)min,受体腹主动脉阻断时间22~38 min、(30±8)min,肝移植手术时间130~310 min、(220±80)min,术中失血35~48 mL、(42±6)mL。术后均无吻合口血栓形成及胆漏发生。4只受体分别于术后48、54、88及96 h死亡,死亡原因均为排斥反应及术中失血过多。结论猪到猴异位辅助性肝移植模型的可重复性强、手术易操作、移植器官灌注良好,可用于猪到非人类灵长类动物肝移植的进一步研究。
Objective To establish a model of ectopic liver transplantation in Chang-Bai small pigs to rhesus monkeys and summarize the main points of the operation. Methods Five pigs with heterotopic liver transplantation were established in healthy male Changbai small domestic pigs and healthy rhesus monkeys. Small white pigs as Changbai donor liver donor, Rhesus as a receptor. The left posterior lobe and part of the right anterior lobe of the Changbai Small House pig were reserved as the donor liver and transplanted to the recipient’s left kidney and left colons. After transiently blocking the blood flow of the abdominal aorta and inferior vena cava of the recipient, the portal vein and the inferior hepatic vena cava of the transplanted liver were anastomosed with the abdominal aorta and inferior vena cava of the recipient, respectively. Ligation of the hepatic artery graft, not to be reconstructed. Postoperative observation of the general situation and survival time. Results Four models of liver transplantation were successfully established. The time for hepatectomy was 24-35 min (, 30 ± 5) min, the time for donor liver dressing was 31-51 min (40 ± 10) min, and the recipient IVC occlusion time was 23 The mean time between occlusion of the abdominal aorta of the recipient and the control group was 36 min, 30 ± 6 min, and the abdominal aorta occlusion time was 22 to 38 min and 30 ± 8 min, respectively. The time of liver transplantation was 130 to 310 min and the mean time was (220 ± 80) min, 35 ~ 48 mL, (42 ± 6) mL. No anastomotic thrombosis and bile leakage occurred after operation. Four recipients died at 48, 54, 88 and 96 h after operation, respectively. All the causes of death were rejection and intraoperative blood loss. Conclusion The reproducibility of pig-to-monkey ectopic adjuvant liver transplantation model is strong, the operation is easy and the perfusion of transplanted organ is good. It can be used for the further study of pig to non-human primate liver transplantation.