Shi Y, Lv Y, Wang B, Zhang Y, Jiang A, Li J H, Zhang X F, Li Q Y, Meng K W, Liu C, Yu L, Pan C E
Department of Hepatobiliary Surgery, First Hospital of Xi'an Jiao Tong University, China.
Transplant Proc. 2006 Nov;38(9):3070-4. doi: 10.1016/j.transproceed.2006.08.174.
Magnetic rings were used for rapid vascular reconstruction in a canine liver transplantation model.
Thirty-two adult mongrel dogs weighing 13 to 16 kg were randomly selected as donors or recipients of transplantations. The recipients were randomly divided into two groups: group A (n = 10) had magnetic rings used for vascular reconstruction without venovenous bypass; group B (n = 6) had vascular reconstruction performed by continuous suturing with splenojugular venovenous bypass.
In group A, the entire operative period was 3.24 +/- 0.49 hours, the durations of clamping the portal vein and the infrahepatic vena cava of the recipient were 5.89 +/- 2.27 minutes and 3.89 +/- 0.73 minutes, respectively. In group B, the entire operative period was 4.12 +/- 0.51 hours with the duration of clamping portal vein and infrahepatic vena cava, 28.33 +/- 6.04 minutes and 12.16 +/- 3.72 minutes (P < .01 vs group A). In group A, mean arterial pressure dropped during the anhepatic phase but recovered quickly after reperfusion. The fluid infusion was about 730.56 +/- 50.56 mL in the group A and a pressor agent was unnecessary. In group B, blood pressure dropped during the anhepatic phase and slowly recovered. The fluid infusion was about 2241.67 +/- 390.78 mL and a pressor agent was used to maintain the blood pressure of the recipient. No twist or thrombus was discovered in the anastomoses group A and the endothelium at the site of anastomosis was entire. In group B, errhysis was common in the anastomotic stomas. Nine of 10 dogs in group A survived more than 3 days, the longest being 8 days, whereas four of the six dogs in group B survived less than 3 days.
The results showed that the anhepatic time was significantly shortened (about 5.89 +/- 2.27 minutes) in group A compared with group B and venovenous bypass was unnecessary. Magnetic rings could be used for rapid vascular reconstruction in canine liver transplantation model. The long-term results of this procedure should be clarified before it is applied in clinical practice in the future.
在犬肝移植模型中使用磁性环进行快速血管重建。
随机选取32只体重13至16千克的成年杂种犬作为移植供体或受体。将受体随机分为两组：A组（n = 10）使用磁性环进行血管重建，不进行静脉-静脉转流；B组（n = 6）通过连续缝合并进行脾颈静脉-静脉转流进行血管重建。
A组手术全程为3.24±0.49小时，受体门静脉和肝下腔静脉阻断时间分别为5.89±2.27分钟和3.89±0.73分钟。B组手术全程为4.12±0.51小时，门静脉和肝下腔静脉阻断时间分别为28.33±6.04分钟和12.16±3.72分钟（与A组相比，P <.01）。A组在无肝期平均动脉压下降，但再灌注后迅速恢复。A组液体输注量约为730.56±50.56毫升，无需使用升压药。B组在无肝期血压下降且恢复缓慢。液体输注量约为2241.67±390.78毫升，需使用升压药维持受体血压。A组吻合口未发现扭曲或血栓形成，吻合部位内皮完整。B组吻合口渗血常见。A组10只犬中有9只存活超过3天，最长存活8天，而B组6只犬中有4只存活不足3天。
结果显示与B组相比，A组无肝时间显著缩短（约5.89±2.27分钟），且无需静脉-静脉转流。磁性环可用于犬肝移植模型中的快速血管重建。在未来应用于临床实践之前，应明确该方法的长期效果。
