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Experimental Research on Efficacy of Sequential Liver and Small intestinal transplantation

序贯肝小肠移植疗效的实验研究

基本信息

批准号：
13470238
负责人：
TAGUCHI Tomoaki
金额：
$ 9.34万
依托单位：
KYUSHU UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2001
资助国家：
日本
起止时间：
2001 至 2004
项目状态：
已结题

项目摘要

Liver transplantation has been reported to induce donor specific tolerance. After tolerance induction by living related liver transplantation, small intestinal graft from the same donor can be accepted without immunosuppression.In the first year and second year, operation technique of living-relatied small intestinal plantation, using porcine model, was established. Ileal graft about 3 m were harvested with vascular pedicle, using two pigs, white pig and black pig. Cutting site of each superior mesenteric vessel was just distal to the most distal colonic branch. Then intestinal grafts were exchanged each other and graft artery was anastosed to Aorta and graft vein was anastomosed to IVC by end-to-side fashion.In the third year, graft motility was monitored by strain gage (S-G) force transducer. S-G transducer was fixed on the serosa. As a result, three parameters of MMC, duration, amplitude, and interval, were impaired in rejected grafts, while, MMC propagated throughout the graft and three parameters were normal in functional grafts. We conclude that he S-G method may afford real-time monitoring of transplanted intestinal motility that can be useful to detect rejection after small intestinal transplantation.In the force year, histological finding was compared with motility study. Histological mild rejection can be detected by S-G method. Combined sequential liver and small intestinal transplantation were succeeded in rat model, however porcine model has not been established yet.

肝移植可诱导供者特异性免疫耐受。活体部分肝移植诱导免疫耐受后，同一供者小肠移植物可在无免疫抑制的情况下被接受，第1年和第2年建立活体部分小肠种植园的操作技术。选用白色猪和黑色猪各2头，切取长约3 m带血管蒂的回肠移植物。每个上级肠系膜血管的切割部位正好位于最远端结肠分支的远端。术后第3年用应变式（S-G）测力传感器监测移植肠的运动，并将移植肠动脉与主动脉端侧吻合，移植静脉与下腔静脉端侧吻合。将S-G传感器固定在浆膜上。结果，MMC的三个参数，持续时间，幅度和间隔，受损排斥移植物，而MMC传播整个移植物和三个参数是正常的功能移植物。结果表明，S-G法可实时监测移植肠的运动，对小肠移植术后排斥反应的诊断有一定的参考价值。S-G法可检测到组织学轻度排斥反应。肝、小肠联合序贯移植在大鼠模型上获得成功，但猪模型尚未建立。