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[利用门静脉内高营养法进行犬的异位肝同种异体移植]

[Heterotopic liver allotransplantation in dogs utilizing intraportal hyperalimentation].

作者信息

Terada M

出版信息

Nihon Geka Gakkai Zasshi. 1986 Apr;87(4):408-17.

PMID:3086706
Abstract

Heterotopic liver transplantation utilizing intraportal hyperalimentation was studied in dog for the purpose of temporary hepatic support for acute liver failure. The liver graft was transplanted in the right lower abdomen of the recipient, and its suprahepatic IVC was anastomosed end-to-side to the infra-renal IVC of the recipient. The celiac artery of the graft was anastomosed end-to-end to the right internal iliac artery of the recipient. An infusion catheter was placed in the donor's portae and intraportal hyperalimentation with insulin was performed. A polyethylene tube (1.7 mm bore) was inserted into the CBD of the graft and led through the body wall as an external biliary drain, after which the recipient's CBD was ligated and transected. The grafts functioned well and excreted bile for 6 days in a non-immunosuppressed group and until death in an immunosuppressed group. Serum bilirubin levels of the recipients increased slightly or were within normal range. At autopsy, the grafts showed no atrophy. Heterotopic liver transplantation with intraportal hyperalimentation will be useful as a temporary hepatic support for acute liver failure in the future.

摘要

为了对急性肝衰竭进行临时肝脏支持,在犬身上研究了利用门静脉内高营养的异位肝移植。将肝移植物移植到受体的右下腹部,其肝上腔静脉与受体的肾下腔静脉进行端侧吻合。移植物的腹腔动脉与受体的右髂内动脉进行端端吻合。在供体门静脉内放置一根输液导管,并进行含胰岛素的门静脉内高营养。将一根聚乙烯管(内径1.7mm)插入移植物的胆总管,并经体壁引出作为外引流管,之后结扎并横断受体的胆总管。在非免疫抑制组中,移植物功能良好并排泄胆汁达6天,在免疫抑制组中则一直维持到死亡。受体的血清胆红素水平略有升高或在正常范围内。尸检时,移植物未显示萎缩。门静脉内高营养的异位肝移植在未来将作为急性肝衰竭的临时肝脏支持而有用。