摘要
目的探讨稳定的小鼠异位小肠移植模型制作方法,为小肠移植排斥反应的研究提供良好的实验工具。方法选用C57BL/6小鼠作供体和BALB/c小鼠作受体进行同种异基因型异位节段性小肠移植。采用小肠供体的门静脉与受体下腔静脉端侧吻合,供体带主动脉片的肠系膜上动脉与受体腹主动脉端侧吻合,供体近端肠管结扎,远端与受体空肠端侧吻合的方式建立异位小肠移植。术后禁食3天,不禁饮,每天分两次经皮下分别给予5%葡萄糖生理盐水2 mL,术后不使用抗生素和免疫抑制剂。小鼠存活超过5 d视为手术成功。结果共行小肠节段性移植30例,术后5 d存活率达70%(21/30)。供体手术时间(41±5.5)min,热缺血时间约0.5 min,供体肠段肠系膜上动脉组织片修整时间约为3 min,供体冷保存时间为(30±7.5)min,受体手术时间(90±7.5)min,其中腹主动脉及下腔静脉阻断时间为(40±3.0)min,静脉吻合时间(10±2.0)min,动脉吻合时间(15±2.5)min,成活小鼠受体手术平均出血量约0.2 mL。手术失败的9例小鼠的死亡原因为动脉吻合口部位狭窄及吻合口处血栓形成(6例),吻合口出血导致出血性休克(2例)和术后腹腔内感染(1例)。结论良好的供体肠段的获取、高质量的血管吻合和肠道吻合及供、受体补液是提高小鼠小肠移植手术成功率的关键。
Objective To investigate the surgical procedures for establishing a reliable murine model of heterotopic small bowel transplantation（SBTx）,with the purpose of providing a good experimental tool for the rejective reaction study in SBTx.Methods C57BL/6 mice were used as donor and the BALB/c mice used as recipient animals.The procedure of segmental heterotopic SBTx in allogenic mice was performed as following： the donor′s portal vein was anastomosed end-to-side to the recipient′s inferior vena cave（IVC）,and then the donor′s superior mesenteric artery（SMA） with an aortic patch was anastomosed end-to-side to the recipient abdominal aorta.Subsequently,proximal end of the graft intestine was ligated and the distant end was anastomosed end-to-side to the recipient′s jejunum.The mice were fasted for 3 days,but free access to water after the operation.In addition,the mice were given 5% glucose-saline solution（2 mL） twice daily by subcutaneous injection,but without use of antibiotic and immunosuppressive therapy.The models survived beyond 5 days were considered to be successful.Results Segmental SBTx were perfomed in 30 mice,with a postoperative day（POD） 5 survival rate of 70 %（21/30）.The operating time in donor was（41±5.5） min,the graft warm ischemic time was about 0.5 min,the time for trimming the aortic patch in SMA was 3 min and cold preservation of donor′s small bowel was（30±7.5） min.The time of recipient preparation and transplantation was（90±7.5） min,in which the abdominal aorta and IVC blockage time was（40±3.0） min,the average time for the vein anastomosis and the arterial anastomosis was（10±2.0） min and（15±2.5） min,respectively.The average bleeding volume was 0.2 mL.The operation failed in 9 cases,due to arterial anastomotic thrombosis and anastomosis stenosis（6 cases）,massive hemorrhage（2 cases） and intraperitoneal infection（1 case）.Conclusions The high quality of the donor′s small bowel segment harvesting,excellent vascular and intestinal anastomosis as well as adequate supplement of liquid to both donor and recipient are all crucial factors to ensure the efficiency and success of SBTx.
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2011年第5期499-502,共4页
China Journal of General Surgery
关键词
小肠/移植
移植
异位
模型
动物
小鼠
Intestine
Small /transpl
Transplantation
Heterotopic
Models
Animal
Mouse
