Peng Yong, Gong Jian-Ping, Yan Lu-Nan, Li Shou-Bo, Li Xu-Hong
Department of Hepatobiliary Surgery, Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, China.
Hepatobiliary Pancreat Dis Int. 2004 Feb;3(1):33-7.
The first orthotopic liver transplantation in rat (ROLT) was reported by Lee in 1973. Kamada innovatively applied cuff technique to ROLT in 1979. However, the operative procedures were highly demanding and the operative mortality was relatively high. The purpose of this study was to improve the model of ROLT, simplify operative procedures, and enhance the successful rate of operation.
Orthotopic liver transplantation was performed in 160 Wistar rats by improved two-cuff technique. The portal vein between donor and recipient was anastomosed with the cuff technique. The same method was used to anastomose the infrahepatic vena cava. The suprahepatic vena cava and the hepatic artery were anastomosed by microvascular suturing and the bile duct was anastomosed end to end by a Teflon catheter.
The average time for donor operation, graft preparation and anhepatic phase was 31 minutes, 14 minutes and 13 minutes, respectively. The anastomosis time for the suprahepatic vena cava, portal vein, infrahepatic vena cava, hepatic artery and bile duct was 7 minutes, 2 minutes, 2 minutes, 8 minutes and 1 minute, respectively. The main causes for operative mortality were pneumothorax, anesthesia, air embolism and massive bleeding, and the successful rate of operation was 92.5%. The causes for death after operation were stoma bleeding, infection, biliary obstruction and graft failure.
The improved two-cuff technique can reduce operative mortality, enhance survival rate, and serve as an ideal method for the establishment of animal model of ROLT.
1973年Lee报道了首例大鼠原位肝移植（ROLT）。1979年Kamada创新性地将套管技术应用于ROLT。然而，手术操作要求极高，手术死亡率相对较高。本研究的目的是改进ROLT模型，简化手术操作，并提高手术成功率。
采用改良双套管技术对160只Wistar大鼠进行原位肝移植。供体与受体之间的门静脉采用套管技术吻合。肝下腔静脉吻合采用相同方法。肝上腔静脉和肝动脉采用微血管缝合，胆管通过聚四氟乙烯导管端端吻合。
供体手术、移植物制备和无肝期的平均时间分别为31分钟、14分钟和13分钟。肝上腔静脉、门静脉、肝下腔静脉、肝动脉和胆管的吻合时间分别为7分钟、2分钟、2分钟、8分钟和1分钟。手术死亡的主要原因是气胸、麻醉、空气栓塞和大量出血，手术成功率为92.5%。术后死亡原因是吻合口出血、感染、胆道梗阻和移植物功能衰竭。
改良双套管技术可降低手术死亡率，提高生存率，是建立ROLT动物模型的理想方法。
