Travis D L, Paulsen A W, Genyk Y
Department of Surgery (Division of Transplantation Services), Baylor University Medical Center, Dallas, Texas, USA.
J Invest Surg. 1996 Mar-Apr;9(2):131-47. doi: 10.3109/08941939609012465.
Several types of isolated perfused porcine liver models have been proposed for the study of hepatic assist, preservation injury, and specific physiologic or pharmacologic mechanisms. The development of a more general in situ isolated perfused model applicable to a broad range of studies is presented. This model eliminates or minimizes the shortcomings of previous models including ischemic injury prior to perfusion, limited range of vascular pressures and flows, nonphysiologic sources of portal and hepatic artery perfusion, and coupling of the liver to uncontrolled whole-body homeostatic mechanisms. Essentially the model as presented can be described as an autologous transplanted liver without preservation or ischemic injury, functioning within an adrenalectomized, cardiac output and temperature-controlled animal. Independent control of the dual hepatic vascular supply is maintained with pulsatile perfusion of the hepatic artery from the left atrium and nonpulsatile perfusion of the portal vein via the portal system. Oxygenators are not required. Hepatic vein pressure can be controlled independently of hepatic blood flow and systemic hemodynamics. Pharmacologic studies are not restricted to drugs whose termination of action is limited to hepatic metabolism because normal routes of drug redistribution, metabolism, and excretion are present. The model exhibits normal oxygen metabolism and classic control of hepatic artery resistance by portal vein blood flow. There are rather obvious significant advantages inherent in this model for tightly controlled hepatic physiologic and pharmacologic studies.
为了研究肝辅助、保存损伤以及特定的生理或药理机制,人们提出了几种类型的离体灌注猪肝模型。本文介绍了一种更通用的原位离体灌注模型的开发,该模型适用于广泛的研究。该模型消除或最小化了先前模型的缺点,包括灌注前的缺血损伤、血管压力和流量范围有限、门静脉和肝动脉灌注的非生理来源,以及肝脏与不受控制的全身稳态机制的耦合。本质上,所介绍的模型可以描述为一个没有保存或缺血损伤的自体移植肝脏,在一个肾上腺切除、心输出量和温度受控的动物体内发挥作用。通过左心房对肝动脉进行搏动灌注,并通过门静脉系统对门静脉进行非搏动灌注,维持对肝脏双重血管供应的独立控制。不需要氧合器。肝静脉压力可以独立于肝血流量和全身血流动力学进行控制。药理学研究不限于作用终止仅限于肝脏代谢的药物,因为存在药物再分布、代谢和排泄的正常途径。该模型表现出正常的氧代谢以及门静脉血流对肝动脉阻力的经典控制。对于严格控制的肝脏生理和药理学研究,该模型具有相当明显的显著优势。