Kim W H, Lee J H, Han S U, Wang H J, Kim M W
Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
Hepatogastroenterology. 1998 Nov-Dec;45(24):2425-9.
BACKGROUND/AIMS: It is well known that hepatocyte transplantation can retain some proper functions, significantly improve the survival rate of rats with different models of acute fulminant hepatic failure, correct some congenital genetic disorders, and improve liver function in cirrhosis. Portal hypertension and hepatic embolization have been described following intrasplenic hepatocyte transplantation. We evaluated the effect of temporary occlusion of splenic vessels on changes in portal vein pressure and on distribution of transplanted hepatocytes after hepatocyte transplantation into the spleen in normal rats.
Liver cirrhosis has been induced in rats by 1% dimethylnitrosamine (Sigma, St. Louis, Mo) dissolved in normal saline at the dose of 10 ml of DMN/Kg, i.p., 3 consecutive days a week for 4 weeks. Donor hepatocytes were harvested by in situ ethylenediaminetetraacetic acid (EDTA) perfusion. Changes in portal vein pressures were monitored by a pressure monitor and distribution of transplanted hepatocytes was assayed by measurement of radioactivity of 51Cr-labeled transplanted hepatocytes according to clamping or non-clamping during intrasplenic hepatocyte transplantation.
The changes in portal pressure remained significantly high 10 min after hepatocyte transplantation in the nonocclusion groups compared to the occlusion groups. However, the changes in portal vein pressures in cirrhotic rats returned to normal faster than in normal rats after cell transplantation in the nonocclusion groups. The distribution of 51Cr-labeled transplanted hepatocytes into the spleen significantly diminished radioactivity of the liver at 10 min, 2 hours, and 24 hours in the occlusion groups compared to the nonocclusion groups. Also, duration of clamping time of splenic vessels did not influence the initial distribution of transplanted hepatocytes at the time of intrasplenic hepatocyte injection.
These results suggested that temporary occlusion of splenic vessels should be routinely used during intrasplenic hepatocyte transplantation.
背景/目的：众所周知，肝细胞移植可保留一些正常功能，显著提高不同急性暴发性肝衰竭模型大鼠的存活率，纠正一些先天性遗传疾病，并改善肝硬化患者的肝功能。脾内肝细胞移植后曾有门静脉高压和肝栓塞的报道。我们评估了正常大鼠脾内肝细胞移植后，临时阻断脾血管对门静脉压力变化及移植肝细胞分布的影响。
用溶解于生理盐水中的1%二甲基亚硝胺（Sigma，圣路易斯，密苏里州）以10 ml DMN/Kg的剂量腹腔注射诱导大鼠肝硬化，每周连续3天，共4周。通过原位乙二胺四乙酸（EDTA）灌注收获供体肝细胞。在脾内肝细胞移植期间，根据是否夹闭脾血管，用压力监测仪监测门静脉压力变化，并通过测量51Cr标记的移植肝细胞的放射性来检测移植肝细胞的分布。
与阻断组相比，未阻断组在肝细胞移植后10分钟门静脉压力变化仍显著升高。然而，在未阻断组中细胞移植后，肝硬化大鼠的门静脉压力变化比正常大鼠更快恢复正常。与未阻断组相比，阻断组在10分钟、2小时和24小时时，51Cr标记的移植肝细胞在脾内的分布显著降低了肝脏的放射性。此外，脾血管夹闭时间的长短并不影响脾内肝细胞注射时移植肝细胞的初始分布。
这些结果表明，在脾内肝细胞移植期间应常规使用脾血管临时阻断。
