Ye Sheng, Han Benli, Dong Jiahong
Institute of Hepatobiliary Surgery of PLA, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
Chin Med J (Engl). 2003 Aug;116(8):1141-5.
To explore the survival time, pathological change and liver regeneration in different kinds of reduced-size liver transplantation in rats using steatotic grafts.
Macrovesicular and microvesicular steatotic rat liver models were established by feeding rats with a diet consisting of 79% standard chow, 20% lard and 1% cholesterol for different time periods. With modified two cuff vascular anastomoses and end-to-end sutures on the bile duct, reduced-size orthotopic rat liver transplantations were performed in an attempt to explore the ratio of graft weight to recipient body weight, recipient original liver weight and histological and electron-microscopic findings in comparison with whole rat liver transplantations.
A one-week survival rates for the rats undergoing whole liver transplantation, and those in the 70% reduced-size orthotopic liver transplantation (ROLT) group, the 60%ROLT group and the 50%ROLT group (grade I macrosteatotic grafts) were 91.67%, 75%, 75% and 25%. A 2-week survival rate was 83.33%, 75%, 58.33% and 0 respectively. And their graft recipient body weight (GRBW) values SD were 3.56% +/- 0.36%, 2.53% +/- 0.15%, 2.28% +/- 0.12% and 1.83% +/- 0.16%, respectively. In grade II macrosteatotic grafts, the one-week survival rate for those undergoing whole liver transplantation and those in the 70% ROLT group was 83.33% and 25%. In the microsteatosis grafts for whole liver transplantation, 70% ROLT, 60% ROLT and 50% ROLT, the one-week survival rate was 83.33%, 75%, 75% and 33.33%; and the 2-week survival rate was 75%, 66.67%, 66.67% and 0, respectively. The survival rate of the 50% ROLT group using grade I macrosteatotic grafts or grafts mainly with microsteatosis was significantly different from that of other groups. While using macrosteatotic grafts in grade II, the 1-week survival rate of the 70% ROLT group was very poor. Pathological findings after operation included liver regeneration and portal space with mild lymphocyte infiltration. Improvement in steatosis and dilation of the central vein and sinusoids was observed in some rats.
In the successful and long-term survival of rat reduced-size liver transplantation using grade Imacrosteatotic grafts or grafts with microsteatosis, the GRBW values should be over 2.28% +/- 0.12%, and the value of graft-recipient liver weight should be over 60%. Steatotic livers in grade II should not be used as grafts in ROLT. Steatosis was improved and even totally cured in some long-term survival rats.
探讨使用脂肪变性供肝的不同类型大鼠减体积肝移植后的生存时间、病理变化及肝再生情况。
通过用含79%标准饲料、20%猪油和1%胆固醇的饲料喂养大鼠不同时间段，建立大鼠大泡性和小泡性脂肪变性肝模型。采用改良的双袖套血管吻合及胆管端端缝合方法，进行大鼠减体积原位肝移植，旨在探讨移植物重量与受体体重之比、受体原肝重量以及与全肝移植相比的组织学和电子显微镜检查结果。
全肝移植大鼠、70%减体积原位肝移植（ROLT）组、60%ROLT组和50%ROLT组（I级大泡性脂肪变性供肝）的1周生存率分别为91.67%、75%、75%和25%。2周生存率分别为83.33%、75%、58.33%和0。其移植物受体体重（GRBW）值标准差分别为3.56%±0.36%、2.53%±0.15%、2.28%±0.12%和1.83%±0.16%。在II级大泡性脂肪变性供肝中，全肝移植大鼠和70%ROLT组的1周生存率分别为83.33%和25%。在小泡性脂肪变性供肝的全肝移植、70%ROLT、60%ROLT和50%ROLT中，1周生存率分别为83.33%、75%、75%和33.33%；2周生存率分别为75%、66.67%、66.67%和0。使用I级大泡性脂肪变性供肝或主要为小泡性脂肪变性供肝的50%ROLT组的生存率与其他组有显著差异。在使用II级大泡性脂肪变性供肝时，70%ROLT组的1周生存率很差。术后病理结果包括肝再生和门管区轻度淋巴细胞浸润。部分大鼠的脂肪变性有所改善，中央静脉和肝血窦扩张。
在使用I级大泡性脂肪变性供肝或小泡性脂肪变性供肝的大鼠减体积肝移植成功并长期存活中，GRBW值应超过2.28%±0.12%，移植物与受体肝重量比值应超过60%。II级脂肪变性肝不应作为ROLT的供肝。部分长期存活大鼠的脂肪变性得到改善甚至完全治愈。
