应用新型磁吻合技术 Suprahepatic 腔静脉重建大鼠原位肝移植模型的研究
1Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering,First Affiliated Hospital, Xi’an Jiaotong University, 2Institute of Advanced Surgical Technology and Engineering,First Affiliated Hospital, Xi’an Jiaotong University, 3Department of Hepatobiliary Surgery,First Affiliated Hospital, Xi’an Jiaotong University, 4Organ Transplantation Center,Tianjin First Center Hospital
Summary
suprahepatic 腔静脉 (SHVC) 的重建仍是大鼠原位肝移植的难点。本文介绍了一种新型的磁吻合技术在大鼠 SHVC 重建中的应用。
Abstract
大鼠原位肝移植模型是移植研究的基础。这是一个非常复杂的动物模型, 需要一个陡峭的学习曲线。采用袖套技术对门静脉 (PV) 和 infrahepatic 腔静脉 (IHVC) 进行吻合, 大大简化了大鼠移植过程。然而, 由于接受者的 suprahepatic 腔静脉 (SHVC) 的前壁短, 袖套技术很难用于重建 SHVC。该领域的大多数研究人员仍然使用手缝合技术进行 SHVC 重建, 这使得它成为大鼠原位肝移植的瓶颈步骤。磁吻合技术 (即, magnamosis) 是一种用两个磁体之间的引力来连接两个容器的方法。我们最近的研究表明, 磁吻合技术优于手缝合技术的 SHVC 重建的大鼠。在本文中, 我们展示了一个逐步的协议, SHVC 重建的大鼠使用新的磁性吻合技术。在该模型中, 采用标准袖套技术对 PV 和 IHVC 进行重建, 采用支架技术进行胆管重建。肝脏再动脉没有执行。磁吻合技术使 SHVC 重建更容易, 大大缩短了 anphepatic 期。经过合理的学习曲线, 即使没有先进的显微外科技术的研究人员也能用这种大鼠肝移植模型产生可靠和可重复的结果。
Introduction
大鼠原位肝移植模型是移植研究的关键1,2。在1973年的3中, 第一个老鼠肝移植是由李et . 描述的。在该模型中, 所有的血管都是用手缝技术重建的。手工缝合技术需要先进的显微外科技术, 这大大限制了它的使用。从那时起, 对原《大鼠肝移植术》的各种修改进行了报道。其中, 1979年卡玛达et. 报告的门静脉 (PV) 和 infrahepatic 腔静脉 (IHVC) 吻合的袖套技术被认为是这一模型的一个重大改进, 因为它大大简化了重建程序4.然而, 由于接受者的 suprahepatic 腔静脉 (SHVC) 的前壁短, 袖套技术很难用于重建 SHVC。该领域的大多数研究人员仍然使用手工缝合技术进行 SHVC 重建, 这使得它成为大鼠肝移植的瓶颈步骤5,6,7。
磁吻合技术 (即, magnamosis) 是一种连接两个容器或其他管状结构的方法, 使用两个磁体8、9、10、11之间的吸引力。磁力逐渐压缩和改造组织成一个强有力的, 无缝线切口吻合12, 13.这种压缩吻合已被证明是有效的人14,15。我们设计了一双磁性环, 专门用于 SHVC 的大鼠的吻合。我们最近的研究表明, 磁吻合技术优于手缝合技术的 SHVC 重建的大鼠肝移植术16。本文的目的是提供一个详细的, 循序渐进的协议, 为 SHVC 重建的大鼠使用新的磁性吻合技术。
Protocol
该议定书是按照《护理和使用实验动物准则》进行的, 并获得了西安交通大学动物实验伦理学委员会的批准。 注意: 本协议中的任何程序都没有在手术显微镜下进行。 1. 术前准备 磁环的设计和形状 (图 1) 通过匹配一对钕铁硼磁环来组装磁吻合装置。 根据大直径、小轴直径、厚度和重量8毫米、5.5 毫米、1毫米、0…
Representative Results
经过大约10次尝试, SHVC 重建的磁吻合技术成功地掌握在一个没有事先进行显微外科训练的研究员身上。SHVC 的重建花费不到2分钟。无肝期阶段为接受者老鼠大约10分钟。再灌注后1、5、30天 SHVC 吻合口无血栓、出血或 angiostegnosis。下腔 cavography 在移植后2周进行。如图 6所示, 磁环完好无损, 血液流动是通过 SHVC 吻合的专利。移植后存活率为95% 天 1, 90% 天…
Discussion
许多临床进展在肝脏移植可以归因于动物研究。大鼠肝移植是在器官保存、移植免疫学、生理学和病理学研究中广泛应用和公认的模型。然而, 这也是一个非常复杂的过程, 需要先进的显微外科技术。尽管在大鼠肝移植手术过程中有许多改进, SHVC 吻合仍然是一个具有挑战性的步骤。本文介绍了一种新的大鼠肝移植 SHVC 重建的磁性吻合技术。该技术的应用减少了 SHVC 重建到2分钟以下的时间, 并将大?…
Divulgazioni
The authors have nothing to disclose.
Acknowledgements
这项工作得到教育部创新团队发展项目资助的支持 (no。IRT16R57), 中国国家自然科学基金 (81470896 号), 西安交通大学青年人才招聘计划研究基金 (cd-rw)。
Materials
| Anesthesia Machine | Harvard | tabletop | Animal anaesthesia |
| PLX7000B HF Mobile Digital C-arm System | Perlong Medical | PLX7000B | It is mainly used for the angiography and photography of various operations |
| Syringe Pump | Mindray | BeneFusion SP5 | intravenous infusion |
| Isoflurane | RWD life Science Co. | anesthetic:for the induction and maintenanceof anesthesia | |
| iohexol | Shanghai General Pharmaceutical Co | intravascular contrast media | |
| heparin sodium injection | SPH No.1 Biochemical & Pharmaceutical Co., LTD | prevent the formation of thrombosis | |
| cefuroxime | Glaxo Operations UK Limited | an antibiotic | |
| buprenorphine | TIPR Pharmaceutical Responsible Co.,Ltd | an analgesic | |
| curved microforceps | Shanghai Medical Instruments (Group) Ltd., Corp. | W40350 | surgical tool |
| hemostatic forceps(straight) | Shanghai Medical Instruments (Group) Ltd., Corp. | J31010 | surgical tool |
| hemostatic forceps(curved) | Shanghai Medical Instruments (Group) Ltd., Corp. | J31020 | surgical tool |
| Satinsky clamp | Shanghai Medical Instruments (Group) Ltd., Corp. | XEC050 | surgical tool |
| needle holder | Shanghai Medical Instruments (Group) Ltd., Corp. | J32010 | surgical tool |
| microneedle holder | Shanghai Medical Instruments (Group) Ltd., Corp. | WBA040 | surgical tool |
| notched forceps | Shanghai Medical Instruments (Group) Ltd., Corp. | J42010 | surgical tool |
| tissue forceps(with hook) | Shanghai Medical Instruments (Group) Ltd., Corp. | J41010 | surgical tool |
| tissue scissor | Shanghai Medical Instruments (Group) Ltd., Corp. | Y00040 | surgical tool |
| surgical scissors | Shanghai Medical Instruments (Group) Ltd., Corp. | Y00030 | surgical tool |
| micro scissors | Shanghai Medical Instruments (Group) Ltd., Corp. | MR-S121T | surgical tool |
| microvessel clips | Shanghai Medical Instruments (Group) Ltd., Corp. | XEC240 | surgical tool |
| straight microforceps(titanium alloy) | Shanghai Medical Instruments (Group) Ltd., Corp. | WCC010 | surgical tool |
| curved microforceps (titanium alloy) | Shanghai Medical Instruments (Group) Ltd., Corp. | WCC020 | surgical tool |
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Citazione di questo articolo
Yang, L., Lu, J., Wang, Y., Zhang, M., Shi, Y., Wei, S., Liu, P., Wu, Z., Lv, Y., Wu, R. A Rat Model of Orthotopic Liver Transplantation Using a Novel Magnetic Anastomosis Technique for Suprahepatic Vena Cava Reconstruction. J. Vis. Exp. (133), e56933, doi:10.3791/56933 (2018).