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目的 :探讨非协调性异种肝移植供肝再灌注障碍与超急性排斥反应的可能关系。方法 :应用改良缝合法建立豚鼠至大鼠的肝移植动物模型 ,观察供肝再灌注 6 0分钟内门脉灌注和肝脏组织超微结构的变化。结果 :移植后 6 0分钟供肝门脉灌注明显减少 ;肝细胞的线粒体明显肿胀 ,线粒体嵴破坏、结构紊乱 ,内质网扩张、脱粒 ,肝细胞狄氏间隙消失 ,肝血窦内可见到血小板和粒细胞粘附、聚集和血栓形成 ,部分内皮细胞消失。受体心肌细胞肿胀 ,肌原纤维排列紊乱、疏松化和断裂 ,线粒体呈多形性 ,大小不等。结论 :豚鼠至大鼠非协调性异种肝移植 6 0分钟时有超急性排斥反应的发生 ,从而导致供肝的灌注障碍 ,同时心肌的受损可以进一步加重供肝的微循环障碍。
Objective: To explore the possible relationship between hepatic ischemia reperfusion injury and hyperacute rejection in non-coordinated heterologous liver transplantation. Methods: The animal model of guinea pig to rat liver transplantation was established by modified suture method. The changes of portal vein perfusion and liver ultrastructure were observed within 60 minutes after reperfusion. Results: The portal vein perfusion was significantly reduced at 60 minutes after transplantation. The mitochondria of hepatocytes were obviously swollen, the mitochondrial cristae were destroyed, the structure was disorganized, the endoplasmic reticulum was dilated, threshing, disappearance of hepatic Dichet’s space, And granulocyte adhesion, aggregation and thrombosis, some of the endothelial cells disappear. Myocardial cell swelling, myofibrillar arrangement disorder, loosening and rupture, mitochondria was pleomorphic, sizes. CONCLUSION: Hyperacute rejection occurs at 60 minutes in guinea pig to rat non-coordinating xenotransplantation liver transplantation, resulting in perfusion disorders in the donor liver, while myocardial damage can further aggravate the microcirculatory disturbance in the donor liver.