肝肾联合移植后移植肝对肾的免疫保护初探
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An experimental study on immune protective role of combined transplantation of liver and kidney
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    摘要:

    目的:建立肝肾联合移植大鼠模型,并初步探讨移植肝是否对移植肾具有免疫保护作用。方法:门静脉和腹主动脉对供肝和供肾进行原位灌注,供肝肝上下腔静脉用显微外科技术缝合,双袖套法吻合肾下下腔静脉及门静脉,带瓣左肾动脉与受体腹主动脉吻合;用支架管重建胆道和输尿管。通过单独肾移植、肝移植和肝肾联合移植生存时间、肾功能及移植肾病理比较研究,探讨其免疫保护作用。结果:用此法建立肝肾联合移植大鼠模型手术无肝期短,手术成功率高。术后肝肾联合移植组较肾移植组生存时间长(P < 0.05),与肝移植组相比,差异无显著性(P > 0.05)。肝肾联合移植组血尿素氮及肌酐明显低于肾移植组(P < 0.05),移植肾排斥反应明显减轻。结论:用该方法建立一期大鼠肝肾联合移植模型方便可行且成功率高;肝肾联合移植时移植肝对移植肾具有免疫保护作用。

    Abstract:

    Objective:To prepare a new combined liver-kidney transplantation(LKT) model in rats and to investigate the protective role of the transplanted liver from transplanted kidney. Methods:In the donor operation,the liver and left kidney were flushed with 4℃ sodium lactate Ringer’s injected through portal vein and aorta,respectively. The superior hepatic vena cava was sutured. A patch of aorta attached to the donor kidney were anastomised to aorta between the donor and the recipient. The ureter and bile duct were anastomised using a simple inside bracket. The parameters of 3 groups were compared,such as survival time,renal function,pathology of the transplanted kidney. Results:The anhepatic duration of recipient was the same as that in Kanada’s method of liver transplantation with a relatively fewer hemodynamic changes and with a higher survival rate. The survival time of LKT recipients was much longer than kidney transplantation recipients(P < 0.05), but similar to liver transplantation recipients(P > 0.05). The concentration of blood urea nitrogen and creatine of combined transplantation group was greater than that of renal transplantation group(P < 0.05). The rejection of the latter was more serious than that of combined transplantation group. Conclusion:This technique of preparing simultaneous liver and kidney transplantation model in rats was feasible, and the simultaneously transplanted liver could protect kidney from rejection.

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朱佳庚,贾瑞鹏,刘 军,苏江浩,孙宏斌,曹志刚,吴剑平.肝肾联合移植后移植肝对肾的免疫保护初探[J].南京医科大学学报(自然科学版),2007,(11):1287-1289

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  • 收稿日期:2007-04-09
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