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肝消融实验模型的历史、伦理、优缺点。

History, ethics, advantages and limitations of experimental models for hepatic ablation.

出版信息

World J Gastroenterol. 2013 Jan 14;19(2):147-54. doi: 10.3748/wjg.v19.i2.147.

Abstract

Numerous techniques developed in medicine require careful evaluation to determine their indications, limitations and potential side effects prior to their clinical use. At present this generally involves the use of animal models which is undesirable from an ethical standpoint, requires complex and time-consuming authorization, and is very expensive. This process is exemplified in the development of hepatic ablation techniques, starting experiments on explanted livers and progressing to safety and efficacy studies in living animals prior to clinical studies. The two main approaches used are ex vivo isolated non-perfused liver models and in vivo animal models. Ex vivo non perfused models are less expensive, easier to obtain but not suitable to study the heat sink effect or experiments requiring several hours. In vivo animal models closely resemble clinical subjects but often are expensive and have small sample sizes due to ethical guidelines. Isolated perfused ex vivo liver models have been used to study drug toxicity, liver failure, organ transplantation and hepatic ablation and combine advantages of both previous models.

摘要

许多医学领域的技术都需要进行仔细的评估,以确定其适应证、局限性和潜在的副作用,然后才能在临床应用。目前,这通常需要使用动物模型,但从伦理角度来看,这并不理想,需要复杂和耗时的授权,并且非常昂贵。在肝消融技术的开发中,就体现了这一过程,从离体肝脏实验开始,然后在临床研究之前,在活体动物中进行安全性和有效性研究。目前主要使用的两种方法是离体非灌注肝脏模型和体内动物模型。离体非灌注模型成本较低,更容易获得,但不适合研究冷源效应或需要数小时的实验。体内动物模型与临床患者非常相似,但由于伦理准则,通常成本较高,样本量较小。离体灌注肝脏模型已被用于研究药物毒性、肝功能衰竭、器官移植和肝消融,结合了前两种模型的优点。

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本文引用的文献

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Cytokine response to ischemia/reperfusion injury in an ex vivo perfused porcine liver model.
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