中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (18): 3413-3416.doi: 10.3969/j.issn.1673-8225.2011.18.045

• 肝移植 liver transplantation • 上一篇    下一篇

恒河猴肝移植后早期死亡的原因分析

冉江华，刘  静，张升宁，李  铸，吴淑媛，梁  宇，张熙冰，李  立   

  1. 昆明医学院附属甘美医院肝胆胰一科，云南省昆明市   650011
  • 收稿日期:2010-10-11 修回日期:2011-01-21 出版日期:2011-04-30 发布日期:2011-04-30
  • 作者简介:冉江华☆，男，1965年生，云南省楚雄市人，汉族，2006年昆明医学院毕业，博士，主任医师，教授，硕士生导师，主要从事肝胆胰外科及器官移植的研究。
  • 基金资助:

    昆明市科技局重大项目(08S100304)。

Cause analysis of early death after liver transplantation in rhesus monkey

Ran Jiang-hua, Liu Jing, Zhang Sheng-ning, Li Zhu, Wu Shu-yuan, Liang Yu, Zhang Xi-bing, Li Li   

  1. First Department of Hepato-biliary- pancreatic Surgery, Ganmei Affiliated Hospital of Kunming Medical College, Kunming  650011, Yunnan Province, China
  • Received:2010-10-11 Revised:2011-01-21 Online:2011-04-30 Published:2011-04-30
  • About author:Ran Jiang-hua☆, Doctor, Chief physician, Professor, Master’s supervisor, First Department of Hepato-biliary- pancreatic Surgery, Ganmei Affiliated Hospital of Kunming Medical College, Kunming 650011, Yunnan Province, China rjh2u@163.com
  • Supported by:

    the Majio Program of Kunming Science and Technology Bureau, No.08s100304*

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摘要：

背景: 影响恒河猴肝移植模型建立的因素较多，模型的成功率和长期生存率较低。
目的：分析恒河猴肝移植后早期死亡的原因。
方法：实验采用改良前和改良后两种方法建立恒河猴肝移植模型。改良后供体采用腹部“十”字形大切口进行快速切取供肝，在修肝时将肝腔静脉、门静脉套管和胆道支撑管留置好，受体采用经典式原位肝移植+二袖套法+胆道支撑管建立稳定的恒河猴肝移植模型。
结果与结论：成功实施的25对恒河猴肝移植模型中，早期死亡7只，其中应用改良前方法移植的9只中死亡6只，用改良后方法移植的16只中死亡1只。死亡7只中因腹腔出血而死亡5只，原发性肝脏无功能死亡1只，气胸导致呼吸衰竭死亡1只。结果表明，恒河猴肝移植后早期死亡的主要原因是腹腔出血；改良后的恒河猴肝移植方法对减少肝移植后出血有明显效果，提高了肝移植后早期生存率。

关键词: 恒河猴, 大动物模型, 肝移植, 死亡, 腹腔出血, 器官移植

Abstract:

BACKGROUND: Various factors contribute to the establishment of liver transplantation models in rhesus monkey, the rate of successful operation and long-term survival are very low.
OBJECTIVE: To analyze the cause of early death following liver transplantation in rhesus monkey.
METHODS: Liver transplantation models were fabricated with the classical and modified methods in rhesus monkeys. Operation of donor was performed quickly by a big crucial incision of abdomen. The improved double-cuff of the portal vein and inferior vena cava were finished, in addition to stay pipe of biliary tract in the process of repairing donor liver. Operation of the receptor was performed by classical orthotopic liver transplantation.
RESULTS AND CONCLUSION: A total of 25 pairs of rhesus monkeys were successfully for establishing liver transplantation models. Seven rhesus monkeys died within early stage of post-operation, including six out of nine monkeys died by using the classical approach and one out of sixteen monkeys died by using the improved approach. There were five of seven monkeys died of intra-abdominal hemorrhage, one died of primary graft nonfunction and one died of respiratory failure. Results indicated that, the major death cause after classical orthotopic liver transplantation in rhesus monkey is abdominal hemorrhage. The improved methods of liver transplantation apparently reduce the hemorrhage and raise early survival rate following liver transplantation.

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