Delriviere L, Kamada N, Kobayashi E, Enosawa S, Goto S
Department of Surgery, University of Queensland, Brisbane, Australia.
J Surg Res. 1994 May;56(5):457-60. doi: 10.1006/jsre.1994.1072.
Despite several technical improvements, orthotopic liver transplantation (OLT) in the rat remains the most difficult experimental microsurgical transplant to perform. The short anhepatic phase tolerated by the rat makes it difficult for beginners to perform the suprahepatic and portal vein anastomoses in the limited time available. To overcome this obstacle, we examined the ability of a portosystemic shunt, induced previously by subcutaneous transposition of the spleen (STS), to decompress the portal system during hepatic pedicle clamping and thus prolong the anhepatic phase of OLT in the rat. Effective drainage was shown by the ability of rats subjected to STS 3 weeks previously to survive portal pedicle clamping of 120 min, while normal rats all died after 90 min of clamping. We demonstrated that, in STS rats, OLT performed with an anhepatic phase of 1 hr had 100% survival at 1 week, while this procedure caused 100% death in normal rats. The ablation in STS rats of the drastic pH decrease and appearance of endotoxins seen in the portal blood of normal rats subjected to "OLT-like" clamping corroborated these results. This application of the STS model to the field of OLT has already proved in our laboratory to be extremely useful during the surgical learning phase of liver transplantation in the rat.
尽管有多项技术改进，但大鼠原位肝移植（OLT）仍是最难实施的实验性显微外科移植手术。大鼠耐受的无肝期较短，这使得初学者难以在有限时间内完成肝上和门静脉吻合。为克服这一障碍，我们研究了先前通过脾脏皮下移位（STS）诱导的门体分流在肝蒂夹闭期间减压门静脉系统的能力，从而延长大鼠OLT的无肝期。3周前接受STS的大鼠能够在门静脉蒂夹闭120分钟后存活，而正常大鼠在夹闭90分钟后全部死亡，这表明了有效的引流。我们证明，在STS大鼠中，无肝期为1小时的OLT在1周时的存活率为100%，而该手术在正常大鼠中导致100%死亡。对接受“类似OLT”夹闭的正常大鼠门静脉血中出现的pH值急剧下降和内毒素进行消融，这一结果在STS大鼠中得到了证实。在我们实验室，将STS模型应用于OLT领域已证明在大鼠肝移植手术学习阶段非常有用。
