Division of Transplantation Surgery, Department of Surgery, Medical University of South Carolina, Charleston, South Carolina.
Department of Surgery, Yale School of Medicine, New Haven, Connecticut.
J Surg Res. 2014 Mar;187(1):297-301. doi: 10.1016/j.jss.2013.10.024. Epub 2013 Oct 18.
Arterialized orthotopic liver transplantation (OLT) in the mouse mimics human liver transplantation physiologically and clinically. The present method of sutured anastomosis for reconstruction of the hepatic artery is complex and is associated with high incidence of complications and failure. This makes the endpoint assessment of using this complex model difficult because of the many variables of the technical aspect.
A total of 14 pairs of donors and recipients from syngeneic male mice were used for arterialized OLT. The grafts were stored in University of Wisconsin solution at 4°C for less than 4 h, and the recipients underwent OLT using a two-cuff technique. The arterial reconstruction was facilitated by the use of a single stent connecting the donor liver artery segment to the recipient common hepatic artery.
All 14 recipients survived with the time for arterial reconstruction ranging from 4-10 min. Patency of the artery was confirmed by transecting the artery near the graft 2 and 14 d after transplantation. At day 2, five of the six arteries transected were patent and at day 14, seven of the remaining eight were patent for an overall patency rate of 85.7%.
The stent-facilitated arterial reconstruction can be done quickly with a high patency rate. This model expands the translational research efforts to address marginal livers such as steatotic livers.
动脉化原位肝移植(OLT)在小鼠中模拟了人类肝移植的生理和临床特征。目前,用于重建肝动脉的缝合吻合方法较为复杂,且并发症和失败的发生率较高。这使得该复杂模型的终点评估变得困难,因为技术方面的变量较多。
共使用 14 对来自同基因雄性小鼠的供体和受体进行动脉化 OLT。移植物在 4°C 的威斯康星大学溶液中储存不到 4 小时,受体接受双套管技术的 OLT。通过使用单个支架将供体肝动脉段连接到受体肝总动脉,来促进动脉重建。
所有 14 名受体均存活,动脉重建时间为 4-10 分钟。在移植后 2 天和 14 天,通过切断靠近移植物的动脉来确认动脉通畅性。在第 2 天,切开的 6 条动脉中有 5 条通畅,在第 14 天,剩下的 8 条中有 7 条通畅,总通畅率为 85.7%。
支架辅助的动脉重建可以快速完成,且通畅率较高。该模型扩大了转化研究的努力范围,以解决脂肪肝等边缘供肝问题。