实用器官移植电子杂志 ›› 2014, Vol. 2 ›› Issue (6): 360-364.DOI: 10.3969/j.issn.2095-5332.2014.06.009

• 论著 • 上一篇    下一篇

大鼠原位肾移植模型的建立及技术改进

林淼 1 ,王继纳 2 ,许明 1 ,戎瑞明 2 ,朱同玉 1,2
  

  1. 1. 复旦大学附属中山医院泌尿外科,上海 200032 ;2. 上海市器官移植重点实验室,上海 200032
  • 出版日期:2014-11-20 发布日期:2021-05-09
  • 基金资助:

    国家自然科学基金面上项目(81070595);

    上海市科学技术委员会科研计划项目,上海市器官移植重点实验室建设项目(09DZ2260300);

    上海市科学技术委员会科研计划项目(09411952000)

  • Online:2014-11-20 Published:2021-05-09

摘要:

目的 探讨建立一种稳定、操作性好的大鼠原位肾移植模型的外科技术及其改进方法。方法 4℃肝素生理盐水原位灌注供肾,手术显微镜下行供肾动脉、静脉、输尿管与受鼠同名血管及输尿管端端吻合。受鼠双侧肾脏一起切除,建立大鼠左侧原位肾移植模型。结果 经过技术改进,建立了稳定、大鼠单侧原位肾移植模型,模型成功率可达 80% 以上。对已完成的 10 对大鼠移植时间进行统计,完成 1 对大鼠肾移植需要(211.00±13.24)分钟,其中供肾切取(87.00±5.34) 分钟,供肾移植(120.00±7.90)分钟;供肾移植中原肾脏切除(27.00±1.12)分钟,动脉吻合(35.00±1.98)分钟,静脉吻合(36.00±3.26)分钟,输尿管吻合(22.00±1.54)分钟。供肾热缺血时间为 30 秒,肾脏冷缺血时间为 100 分钟。10 对原位肾移植大鼠中 8 对大鼠存活时间大于 3 天,移植肾形态、功能良好,其余2 对大鼠死亡原因包括吻合口出血、血栓形成、尿漏等。结论 本文所述方法和改进技巧有利于建立一种稳定的、适用于器官移植免疫学研究的大鼠原位肾移植模型。

关键词:

Abstract:

Objective To investigatethe procedure improvement of building a stable and operational orthotopic renal transplantation model in rats. Methods The left kidney was removed from the donor rat after perfusing it with ice-cold heparinized salinethrough the abdominal aorta. The donor kidney was transplantedorthotopically into a bilaterally nephrectomized recipient by end-to-end anastomosis of the left renal vessels andthe left ureter using microsurgical technique. Results According to the improved procedure,a stable and easily operational renal transplantation model was set up with a success rate above 80%. 10 pairs of rats have received renal transplantation surgeries till now. The mean total surgery time was(211.00±13.24)minutes,with donor nephrectomy of(87.00±5.34)minutes and renal transplantation of(120.00±7.90)minutes. During the transplantation surgery,the time of nephrectomies was(27.00±1.12)minutes,with artery anastomosis of(35.00±1.98)minutes,vein anastomosis of(36.00±3.26)minutes,and ureteroureterostomy of(22.00±1.54)minutes. The mean warm ischemia time was 30 seconds,and the mean cold ischemia time was 100 minutes. 3-day survival rate was 80% with good graft function. 2 recipients died of anastomotic bleeding,thrombosis,urine leakage,and so on. Conclusion With the procedure improvement,it was very helpful to set up a stable and operational rat renal transplantation model forimmunological researches.coping styles of liver transplant recipients were 19.38±3.98,15.01±3.17 and 8.01±2.67,respectively. The score of avoidance was significantly higher than that of the Feifel norm(P = 0.008),whereas the score of confrontation and acceptance-resignation were significantly lower than that of the Feifel norm(P = 0.046 and P = 0.001 respectively). The physical component summary(PCS)and mental component summary(MCS)scores of the SF-36 were 50.96±6.80 and 50.10±9.22,respectively. The recipients had lower scores of physical function(PF),domainsof body pain(BP)and general health(GH)compared to the norm(P < 0.05). However,there were no statistical differences between the recipients and norm of the scores of role-physical(RP),regarding vitality(VT),social functioning(SF),role-emotional(RE)(P > 0.05),while the mental health(MH)

score was significantly higher than that of the norm(P 0.01). The QOL scores in liver transplant recipients were negatively correlated with acceptance-resignation scores(r -0.310 to -0.542,P 0.05 or P 0.01),but not correlated with confrontation or avoidance scores. Conclusion Liver transplant recipients have significantly better MCS domain scores than PCS domain scores. Acceptance-resignation coping mode has negative impact on the QOL of liver transplantation recipients.