A Novel End-to-Side Anastomosis Technique for Hepatic Rearterialization in Rat Orthotopic Liver Transplantation to Accommodate Size Mismatches between Vessels
A Novel End-to-Side Anastomosis Technique for Hepatic Rearterialization in Rat Orthotopic Liver Transplantation to Accommodate Size Mismatches between Vessels
复制标题
DOI：
10.1159/000324905
复制
发表时间：
2011-01-01
影响因子：
1.6
通讯作者：
Dahmen, U.
中科院分区：
文献类型：
--
作者：
Huang, H.;Deng, M.;Dahmen, U.
背景/目标：我们提出了我们的修改原位大鼠肝移植缝合动脉吻合，以及文献调查和分析现有的技术reterialization方面的技术困难和潜在的局限性。研究方法：供体肝总动脉（CHA）与受体肝固有动脉（PHA）的扩大管腔吻合，采用端侧间断缝合技术，与供体CHA的尺寸相匹配。在术中和收获肝移植物时（术后第2天和第28天）评估了肝动脉化的血管通畅性。动脉化对肝脏形态的影响通过组织学检查证实，并与非动脉化大鼠原位肝移植进行比较。结果：与PHA相比，CHA具有显著更大的直径（高达3倍），这代表了相当大的尺寸不匹配。吻合术（包括尺寸调整）需要15-25分钟。所有的动脉瘤均在后动脉化后5分钟和两个采集时间点立即通畅。在动脉化组中，肝小叶结构完整，而在非动脉化组中观察到中度胆管增殖和门静脉/小叶淋巴细胞浸润。结论：这项新技术是一种耗时且具有显微外科挑战性的手术，但普遍适用且稳健，甚至可以适应血管直径严重不匹配的情况。版权所有（C）2011 S. Karger AG，巴塞尔
Background/ Aims: We present our modification of a sutured arterial anastomosis in orthotopic rat liver transplantation as well as a literature survey and analysis of the existing techniques of rearterialization with regard to technical difficulties and potential limitations. Methods: The donor common hepatic artery (CHA) was anastomosed to the enlarged lumen of the recipient proper hepatic artery (PHA), tailored to match the size of the donor CHA, with an end-to-side interrupted suture technique. Vascular patency of hepatic rearterialization was assessed both intraoperatively and at the time the liver grafts were harvested (postoperative days 2 and 28). The effect of arterialization on hepatic morphology was confirmed by histological examination and compared to nonarterialized rat orthotopic liver transplantation. Results: The CHAs had a significantly larger diameter (up to 3-fold) compared to the PHAs, which represents a considerable size mismatch. The anastomosis procedure including the size adaptation required 15-25 min. All anastomoses were patent immediately, 5 min after rearterialization and at both harvest time points. The liver lobular architecture was intact in the rearterialized group, whereas a moderate degree of bile duct proliferation and portal/lobular lymphocytic infiltration were observed in the nonarterialized group. Conclusion: The new technique is a time-consuming and microsurgically challenging but universally applicable and robust procedure accommodating even a substantial mismatch in vessel diameter. Copyright (C) 2011 S. Karger AG, Basel