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犬原位部分肝移植可不进行供肝冷灌注。从能量代谢方面评估其可行性。

Orthotopic partial liver transplantation in dogs can be performed without cold perfusion of the donor liver. Evaluation of its feasibility in terms of energy metabolism.

作者信息

Tokunaga Y, Zaima M, Tanaka K, Maki A, Katayama T, Sakai Y, Egawa H, Kiuchi T, Yamamoto Y, Ueda J

机构信息

Second Department of Surgery, Faculty of Medicine, Kyoto University, Japan.

出版信息

Eur Surg Res. 1989;21(3-4):137-44. doi: 10.1159/000129016.

Abstract

To investigate the feasibility of obtaining grafts from living, genetically related adult donors without any complicated harvesting techniques, orthotopic partial liver transplantation (PLT) without cold perfusion of the donor graft was evaluated in beagles by assessing the graft viability using ketone body ratio (KBR). Ten PLT were performed under venovenous bypass. The left half of the donor liver was transected in situ followed by systemic heparinization, and immediately implanted with care taken to leave the recipient's inferior vena cava intact, and to maintain the normothermic state without cold perfusion. Four of ten dogs survived for 5 days or longer (longest survival was 9 days) and died of other causes than graft dysfunction. Four others died of thromboembolitic episode, accidental bleeding or technical failure. Two dogs died of graft dysfunction. The changes in KBR in 5 dogs without fatal complications after transplantation were maintained within normal range thereafter. These results suggest that the PLT without cold perfusion of donor graft is possible from the viewpoint of energy metabolism.

摘要

为了研究在不采用任何复杂获取技术的情况下从有基因相关性的成年活体供体获取移植物的可行性,通过使用酮体比率(KBR)评估移植物活力,在比格犬中对未进行供体移植物冷灌注的原位部分肝移植(PLT)进行了评估。在静脉 - 静脉转流下进行了10例PLT。在原位横断供体肝脏的左半部分,随后进行全身肝素化,并立即小心植入,注意保持受体下腔静脉完整,并在不进行冷灌注的情况下维持常温状态。10只狗中有4只存活了5天或更长时间(最长存活9天),死于除移植物功能障碍以外的其他原因。另外4只死于血栓栓塞事件、意外出血或技术失败。2只狗死于移植物功能障碍。移植后5只无致命并发症的狗的KBR变化此后维持在正常范围内。这些结果表明,从能量代谢的角度来看,不进行供体移植物冷灌注的PLT是可行的。

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