Establishment of a non-venous bypass orthotopic liver transplantation model in Bama miniature pigs
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摘要:
目的 建立重复性和稳定性好的巴马小型猪非静脉转流原位肝移植模型。 方法 选用12只巴马小型猪随机分为供体组（n=6）和受体组（n=6），行非静脉转流原位肝移植术，术中缩短无肝期的时间、维持无肝期血压稳定以及加强术中麻醉与体液管理。观察并记录受体的手术时间、无肝期、存活情况，监测术中心率、平均动脉压（MAP）、动脉血气分析改变，检测围手术期肝功能情况。 结果 6只巴马小型猪中，1只术中死亡移植失败，其余5只的手术时间为（247±27）min, 无肝期为（46±4）min，其中3只存活2周以上。与无肝前期相比，无肝期动物心率明显加快，MAP明显降低至（46±6）mmHg，血液pH值、剩余碱（BE）、HCO3-均下降，血清K+升高（均为P < 0.05）。新肝期巴马小型猪MAP上升，心率变慢，血液pH值、BE、HCO3-升高，血清K+降低（均为P < 0.05）。关腹时MAP及血气各指标及血清K+基本恢复至无肝前期水平。与术前相比，术毕时丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、乳酸脱氢酶（LDH）、碱性磷酸酶（ALP）明显升高（均为P < 0.05），AST升高变化最明显，术后第2日开始逐渐下降。γ-谷氨酰转移酶（GGT）无升高变化，总胆红素（TB）术后第5日急剧升高。与术前相比，术毕时总蛋白（TP）、白蛋白（ALB）均明显下降（均为P < 0.05），术后第1日开始逐渐回升。 结论 非静脉转流巴马小型猪原位肝移植模型手术便捷、重复性高、存活率高，可以作为标准化的肝移植模型。 Abstract:Objective To establish a non-venous bypass orthotopic liver transplantation model in Bama miniature pigs with high repeatability and stability. Methods Twelve Bama miniature pigs were randomly divided into the donor group (n=6) and recipient group (n=6). Pigs underwent non-venous bypass orthotopic liver transplantation. The time of anhepatic phase during operation was shortened, blood pressure during anhepatic phase was stably maintained, and management of anesthesia and body fluid during operation were strengthened. The operation time, anhepatic phase and survival status of the recipients were observed and recorded. The intraoperative heart rate, mean arterial pressure (MAP) and changes in arterial blood gas analysis were monitored. The perioperative liver function was evaluated. Results Among 6 Bama miniature pigs, 1 died from transplantation failure intraoperatively. The operation time of the remaining 5 pigs was (247±27) min and the time of anhepatic phase was (46±4) min. Three animals survived for more than 2 weeks. Compared with the preanhepatic phase, the heart rate of the animals was significantly faster, MAP was considerably reduced to (46±6) mmHg, blood pH value, base excess (BE) and HCO3- level were all significantly decreased and serum level of K+ was significantly elevated during the anhepatic phase (all P < 0.05). In the neohepatic phase, MAP of Bama miniature pigs was significantly increased, heart rate was dramatically slower.Blood pH value, BE, HCO3- level were significantly increased and serum level of K+ was significantly declined (all P < 0.05). During abdominal closure, MAP, blood gas indexes and serum level of K+ were almost recovered to those in the preanhepatic phase. Compared with preoperative levels, the levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST), lactate dehydrogenase(LDH)and alkaline phosphatase(ALP)were significantly increased after operation (all P < 0.05), the change in AST was the most obvious, and it gradually decreased at postoperative 2 d. The level of γ-gutamyl transferase(GGT) did not significantly elevated. The level of total bilirubin (TB) was evidently elevated at postoperative 5 d. Compared with the preoperative levels, the levels of total protein (TP) and albumin (ALB) were significantly decreased after operation (both P < 0.05), and began to gradually increase at postoperative 1 d. Conclusions The non-venous bypass orthotopic liver transplantation model of Bama miniature pig is convenient, with highly reproducible and survival rate, which can be utilized as a standardized liver transplantation model. -
图 2 巴马小型猪术中心率、MAP及动脉血气分析变化
Figure 2. The change of heart rate, MAP and arterial blood gas analysis during operation in Bama miniature pig
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