猪原位腹部多脏器移植无静脉-静脉转流术

Orthotopic abdominal multivisceral transplantation without venovenous bypass in pigs.

作者信息

Ai L M, Peng C H, Wu Y L, Cao L P, Fang H Q, Liu Y B, Peng S Y

机构信息

Department of Surgery, Second Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China.

出版信息

Transplant Proc. 2007 Jan-Feb;39(1):273-7. doi: 10.1016/j.transproceed.2006.10.215.

DOI:10.1016/j.transproceed.2006.10.215

PMID:17275520

Abstract

BACKGROUND

Because venovenous bypass (VVB) can cause specific complications, a simplified orthotopic abdominal multivisceral transplantation (MVTX) technique without VVB in pigs has been evaluated in terms of morbidity and mortality.

MATERIALS AND METHODS

Outbred large-white pigs weighing 25 to 40 kg of random sex underwent MVTX operation. After in situ cold perfusion through the aorta and superior mesenteric vein, the multivisceral allograft was procured from the donor and tailored at the back table. The multivisceral allograft, including liver, pancreas, stomach, duodenum, and proximal 2 m of jejunum, was en bloc transplanted into recipient after resection of entire foregut and midgut; VVB was not used. We analyzed the hemodynamic change, arterial blood gas data, and fluid requirements intraoperatively.

RESULTS

Among 25 MVTXs, 19 (76%) animals survived after the operation. Without using an immunosuppressant, postoperative survival time was 2 to 146 hours. Ten recipient pigs died within 24 hours. Seven animals were lost between postoperative days 2 and 5. Two pigs survived for more than 5 days. The recipient pigs were mostly in a state of hypovolemic shock and metabolic acidosis during the reperfusion phase.

CONCLUSIONS

Despite a high morbidity and mortality, the simplified technique without VVB is feasible to successfully achieve MVTX in the pig.

摘要

背景

由于静脉-静脉转流（VVB）可引发特定并发症，已对猪体内不采用VVB的简化原位腹部多脏器移植（MVTX）技术的发病率和死亡率进行了评估。

材料与方法

选用体重25至40千克、性别随机的远交大白猪进行MVTX手术。经主动脉和肠系膜上静脉进行原位冷灌注后，从供体获取多脏器移植物并在后台进行修整。将包括肝脏、胰腺、胃、十二指肠和空肠近端2米的多脏器移植物在切除整个前肠和中肠后整块移植到受体中；未使用VVB。我们分析了术中的血流动力学变化、动脉血气数据和液体需求。