Department of Hepatobiliary Surgery, First Affiliated Hospital of Kunming Medical College, Kunming, 650032, China.
Front Med. 2011 Mar;5(1):106-10. doi: 10.1007/s11684-011-0113-2. Epub 2011 Mar 17.
Establishing a model for small-for-size liver transplantation is the basis for this study of partial and living donor graft liver transplantation. This study aims to explore a simpler and more effective way of establishing a 30% small-for-size liver transplantation in rats. Sprague-Dawley rats were selected as the donors and recipients. Small-for-size orthotopic liver transplantation was performed using Kamada's two-cuff method. The donor's liver was flushed via the abdominal aorta and hepatectomy was performed in situ. The animals were divided into three groups depending on the graft selected, with 40 pairs of rats in each group. In group I, the median lobe of the liver was used as graft; in group II, the right half of the median lobe and the right lobe were used as graft; and in group III, the median and right lobes were used as graft. In groups I and II, the bodyweights of donors were the same as those of recipients; however, in group III the bodyweights of donors were 100-120 g less than those of the recipients. The duration needed for transplantation, the 7-day survival rates, and the technical complication rates were compared among these three groups. The time required for hepatectomy was shorter in group III compared with groups I and II (8.8±0.7 min vs. 11.5±1.1 min and 10.1±1.0 min, P = 0.001). The cold ischemia time for the grafts, the anhepatic times, and the transplantation times for the recipients were not significantly different among the three groups. Compared with groups I and II, the incidence of bleeding, bile leakage, and inferior vena caval strictures were significantly decreased in group III (P<0.05). No significant differences between the three groups were found based on other complications after the operation (P>0.05). Group III had better 7-day survival rates and longer median survival times but the differences were not statistically significant. The method of small for donor bodyweight using the median and right lobes for grafting may be a more effective and simpler way of establishing a 30% small-for-size liver transplantation in rats, as shown by the shorter hepatectomy time and the occurrence of fewer complications after the operation.
建立小体积肝移植模型是本研究进行部分和活体供体肝移植的基础。本研究旨在探索一种更简单、更有效的方法，在大鼠中建立 30%小体积肝移植。选用 SD 大鼠作为供体和受体，采用 Kamada 双套管法进行小体积原位肝移植。经腹主动脉灌洗供肝，原位肝切除。根据供肝选择将动物分为三组，每组 40 对。Ⅰ组供肝采用中叶；Ⅱ组供肝采用中叶加右半肝；Ⅲ组供肝采用中右两叶。Ⅰ、Ⅱ组供受体体重相同，Ⅲ组供体体重比受体轻 100-120g。比较三组大鼠移植时间、7 天存活率和技术并发症发生率。与Ⅰ、Ⅱ组比较，Ⅲ组肝切除时间更短（8.8±0.7 min 比 11.5±1.1 min 和 10.1±1.0 min，P=0.001）。三组供肝冷缺血时间、无肝期和受体移植时间差异无统计学意义。与Ⅰ、Ⅱ组比较，Ⅲ组术中出血、胆漏和下腔静脉狭窄发生率明显降低（P<0.05）。三组术后其他并发症发生率差异无统计学意义（P>0.05）。Ⅲ组 7 天存活率和中位生存时间均较好，但差异无统计学意义。采用中右两叶供肝，使供体体重与受体体重的比例更小，可能是一种更有效、更简单的方法，可缩短肝切除时间，减少术后并发症。
