Study of orthotopic and auxiliary partial liver grafting from living donor

1)建立仔猪全肝分离后的辅助部分肝移植手术，通过台架手术分离左内外叶，将左叶异位移植到受者肝脏的下部，使后者保持原状。移植物肝静脉与受体下腔静脉吻合，斜移植物门静脉门静脉吻合，阻断受体肝门周围血流吻合，使移植物肝功能得以实现。目前还没有稳定的结果，但我们有不少于5周的存活病例。2)原位部分肝移植方法的建立将仔猪左叶（左内叶、左外叶）原位移植于受体，分离出全肝。从供体身上摘取部分肝脏并分离出受体的全肝需要相当大的技巧，但在猪身上进行原位部分肝脏移植，供体的存活率不少于5天。此外，这些移植的肝脏被证实具有再生肥厚和良好的功能。3)检查部分肝移植的移植物大小及免疫反应从检查受体所需的移植物肝脏大小、移植物肝脏的大小及再生情况出发，采用大鼠原位部分肝移植与全肝移植存活率相近，术后5天移植物肝脏重量恢复到原来的重量。组织学上，术后2天肝细胞核分裂频繁，术后5天肝细胞核分裂少见。相反，同基因20%部分肝移植术后不仅肝功能增强，生存率明显降低，而且肝脏ATP再合成降低，内毒血症升高。以上结果表明，部分肝移植至少30%成功维持了受者的生命。在30%部分肝移植大鼠模型中检测肝脏抑制剂提示FK506对肝功能障碍的影响小于CyA。少

1) Establishment of auxiliary partial liver grafting procedure after isolating the whole liver of a young pig, left internal and external lobes were separated by bench surgery, and the left lobe was heterotopically grafted in the lower part of the recipient's liver, leaving the latter, as it was. Anastomosis of the graft hepatic vein with the recipient's IVC, porto-portal anastomosis by oblique graft portal vein and through blood flow blockage around the recipient hepatic hilum enable us to make the grafted liver functional No stable results have been obtained yet, but we have some cases of not less than 5-week survival.2) Establishment of orthotopic partial liver grafing procedureLeft lobe (left internal lobe, external lobe) of a young pig was orthotopically grafted in the recipient, of which the whole liver was isolated. Harvest of a partial liver from the donor and isolation of the recipient's whole liver require considerable amount of skill, but orthotopic partial liver grafting fr … More om the donor in pigs obtained not less than 5-day survival. Moreover, these grafted livers were confirmed to show regenerative hypermat rophy and good function.3) Examination of the graft size for partial liver grafting and immunological reactionWith the view of examining the size of graft liver necessary for the recipient, the size and the regeneration of the graft liver were examined, using rat orthotopic partiall liver grafting showed approximately similar survival rate to total liver grafting and had grafted liver weight recovered to its original weight 5 days postoperatively. Histologically, hepatocytic karyokinesis was noted frequently 2 days postoperatively, but rarely 5 days postoperatively. On the contrary, isogeneic 20%-partial liver grafting showed not only enhanced postoperative hepatic dysfunction and remarkably lowered survival rate, but also lowered hepatic ATP resynthesis and higher endo-toxihemia compared with the former grafting. The above results indicated that partial liver grafting>30% at least was successful in keeping the recipients life. Examination of iunosuppressants in rat's 30% partial liver grafting model suggested FK506 to be less responsible for hepatic dysfunction than CyA. Less