Kumagae T
Second Department of Surgery, Kagoshima University Faculty of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1988 Jul;89(7):1058-65.
Abdominal multi-organ transplantation including the liver, gallbladder, spleen, pancreas, kidneys, adrenal glands and gastrointestinal tract was attempted in 8 dogs. Each experiment was discontinued when the recipient deteriorated. Immersion hypothermia was introduced in both the donor and recipient until the esophageal temperature reached 27-30 degrees C. Whole abdominal organs of the donor were removed in an en-bloc fashion at 20 degrees C of the graft temperature after additional cooling by ice slush scattering into the abdominal cavity. Transplantation was carried out orthotopically in the following sequence: (1) the proximal aorta, (2) suprahepatic vena cava, (3) distal aorta, (4) infrahepatic vena cava. The alimentary tract was reconstructed by gastro-gastrostomy and colo-colostomy. The ureters were implanted in the bladder. Cold ischemic time of the graft was about 40 minutes. Heparin was not used throughout the procedure. Five out of eight dogs were alive for more than 24 hours and two of them survived for 60 hours with good recovery. No immunosuppressant was given. Though the result in the present study was far from satisfaction, the experiment may provide a possibility of a new experimental model for transplantation, especially regarding pathophysiology and interrelationship of the transplanted complex organs.
对8只犬尝试进行包括肝脏、胆囊、脾脏、胰腺、肾脏、肾上腺和胃肠道的腹部多器官移植。当受体情况恶化时,每个实验均终止。供体和受体均采用浸泡低温法,直至食管温度达到27 - 30摄氏度。在通过向腹腔内喷洒冰泥进一步降温后,在移植物温度为20摄氏度时,以整块方式切除供体的全腹部器官。移植按以下顺序原位进行:(1) 近端主动脉,(2) 肝上腔静脉,(3) 远端主动脉,(4) 肝下腔静脉。消化道通过胃-胃吻合术和结肠-结肠吻合术重建。输尿管植入膀胱。移植物的冷缺血时间约为40分钟。整个过程未使用肝素。8只犬中有5只存活超过24小时,其中2只存活60小时且恢复良好。未给予免疫抑制剂。尽管本研究结果远不尽人意,但该实验可能为移植提供一种新的实验模型,尤其是关于移植复合器官的病理生理学和相互关系。