Mark W, Candinas D, Hechenleitner P, Hengster P, Obrist P, Klima G, Margreiter R
Department of Transplant Surgery and Daniel Swarovski Research Laboratory, University Hospital of Innsbruck, Austria.
Microsurgery. 2000;20(3):139-42. doi: 10.1002/(sici)1098-2752(2000)20:3<139::aid-micr8>3.0.co;2-9.
Guinea pig-to-rat orthotopic liver transplantation is associated with serious technical problems contributing to impaired graft perfusion and primary graft failure. In order to shorten the procurement procedure and thereby minimize liver damage before flushing, a simplified technique for infrahepatic caval reconstruction was developed. Dissection of the infrahepatic vena cava (IHVC) from adrenal glands and renal and lumbar veins represents the most difficult and time-consuming part of the donor operation, which is often not well tolerated by the animal; we avoided this step by using an isogeneic vena cava interposition graft (VCIG) following in situ perfusion. This graft is connected with the IHVC transsected just below the liver with a cuff technique. Donor operations lasted 15 to 20 minutes with the new technique (n = 7) compared to 52 to 76 minutes with conventional technique (n = 7). Reduced operating time was associated with markedly improved graft perfusion and significantly better graft survival. This modification of the donor procedure for the guinea pig-to-rat liver xenograft using a VCIG significantly reduces operating time and improves reperfusion and recipient survival.
豚鼠到大鼠的原位肝移植存在严重的技术问题，这些问题会导致移植物灌注受损和原发性移植物功能衰竭。为了缩短获取程序，从而在冲洗前将肝损伤降至最低，我们开发了一种简化的肝下腔静脉重建技术。从肾上腺、肾静脉和腰静脉分离肝下腔静脉（IHVC）是供体手术中最困难、最耗时的部分，动物通常对此耐受性不佳；我们通过在原位灌注后使用同基因腔静脉间置移植物（VCIG）避免了这一步骤。该移植物通过袖套技术与在肝脏下方横断的IHVC相连。新技术（n = 7）的供体手术持续15至20分钟，而传统技术（n = 7）的供体手术持续52至76分钟。手术时间的缩短与移植物灌注的显著改善和移植物存活率的显著提高相关。使用VCIG对豚鼠到大鼠肝异种移植供体程序的这种改进显著缩短了手术时间，并改善了再灌注和受体存活率。
