Kim H, Kim H, Lee J-I, Ahn S W, Hong S K, Yoon K C, Kim H-S, Choi J-Y, Oh D, Yi N-J, Yang J, Lee K-W, Suh K-S
Department of Surgery, Seoul National University, College of Medicine, Seoul, Korea.
Department of Medicine, Seoul National University College of Medicine, Seoul, Korea.
Transplant Proc. 2017 Jun;49(5):1150-1152. doi: 10.1016/j.transproceed.2017.03.024.
Herein, we report our experience of performing allogeneic orthotopic liver transplantation (LT) in nonhuman primates. We designed an allogeneic ABO-compatible orthotopic LT model in monkeys in a manner similar to that used in humans. We applied almost the same surgical procedures used for human conventional deceased donor LT. A total of 6 monkeys underwent allogeneic LT. One cynomolgus monkey aged 45 months (3.4 kg) and 5 rhesus macaque monkeys aged 50.2 ± 14.8 months (5.40 ± 0.33 kg) were used as recipients. In the donor surgery, the liver was perfused in situ through the aorta using cold histidine-tryptophan-ketoglutarate solution. The portal vein (diameter, 5-10 mm), supra- and infra-hepatic inferior vena cava (IVC) (diameter, 12-15 mm), and common bile duct (diameter, 1.5-3.0 mm) were dissected out. The hepatic artery was kept in continuity with the celiac trunk and abdominal aorta up to the iliac bifurcation (diameter, 5-6 mm). The mean graft weight was 102.0 g (94.8-111.0 g). Recipient surgery was conducted in parallel. After recipient hepatectomy, the graft was implanted. The suprahepatic IVC and portal vein were anastomosed to those of the graft. After reperfusion, the infrahepatic IVC was anastomosed. The aorta conduit of the graft was anastomosed to the infrarenal aorta of the recipient in a retrocolic end-to-side manner. Biliary reconstruction was performed in a duct-to-duct anastomosis with cholecystectomy. Mean operative time was 107.0 minutes for donor and 198.2 minutes for recipient. There was one operative death due to unknown cause. In conclusion, for allogeneic orthotopic LT in nonhuman primate model, we can apply almost the same procedure used for human conventional deceased donor LT in a similar manner.
在此，我们报告我们在非人灵长类动物中进行同种异体原位肝移植（LT）的经验。我们以类似于人类的方式设计了一种猴子同种异体ABO相容原位肝移植模型。我们应用了几乎与人类传统尸体供肝LT相同的外科手术程序。共有6只猴子接受了同种异体肝移植。一只45个月大（3.4千克）的食蟹猴和5只50.2±14.8个月大（5.40±0.33千克）的恒河猴被用作受体。在供体手术中，使用冷组氨酸-色氨酸-酮戊二酸溶液通过主动脉对肝脏进行原位灌注。解剖出门静脉（直径5-10毫米）、肝上下腔静脉（IVC）（直径12-15毫米）和胆总管（直径1.5-3.0毫米）。肝动脉与腹腔干和腹主动脉保持连续直至髂总动脉分叉处（直径5-6毫米）。移植肝平均重量为102.0克（94.8-111.0克）。受体手术并行进行。受体肝切除术后，植入移植肝。将肝上下腔静脉和门静脉与移植肝的相应血管进行吻合。再灌注后，吻合肝下腔静脉。移植肝的主动脉导管以结肠后端侧吻合的方式与受体的肾下腹主动脉吻合。采用胆管对胆管吻合并切除胆囊的方式进行胆道重建。供体平均手术时间为107.0分钟，受体为198.2分钟。有1例因不明原因的手术死亡。总之，对于非人灵长类动物模型中的同种异体原位肝移植，我们可以以类似的方式应用几乎与人类传统尸体供肝LT相同的程序。
