EXPERIMENTAL STUDIES ON AUXILIARY LIVER TRANSPLANTATION BASED ON REDOX THEORY

1.猪血酮体生化检测方法的建立。在本研究中，有必要测量血液酮体比率（乙酰乙酸/b-羟基丁酸，KBR）的变化在两个动脉血的肝衰竭的猪和辅助移植肝的肝静脉。我们发现猪的动脉酮体比人、兔和大鼠的动脉酮体低。作为受体的部分肝切除模型。本实验首先在90%肝切除的猪上建立了肝功能衰竭模型。然而，血流动力学稳定的模型不能主要由于大量失血。在该模型中，辅助肝移植导致受体和辅助肝的KBR降低。在这个模型中，我们未能评估KBR作为移植失败指标的可用性。建立猪门腔静脉分流术肝缺血致急性肝衰竭模型。通过夹闭肝三联体6小时造成急性肝衰竭。在肝缺血期间，转氨酶、动脉血氨和钾水平逐渐升高。PT和PTT延长。在肝三联体阻断期间，动脉酮体几乎检测不到。开放后2小时内，动脉KBR暂时恢复，但比值继续下降。所有猪在松开夹钳后8小时内死亡。提示通过测定该模型动脉KBR的变化，可以评价离体灌注肝或辅助移植肝提供代谢支持的效率.由于辅助性肝移植在这只动物被认为是可能的，没有大量失血，我们已经开始评估的可用性KBR作为一个指标的移植失败，在这个模型。

1. Establishment of biochemical assays of porcine blood ketone bodies. In this study, it is essential to measure the changes in blood ketone body ratio (acetoacetate/b-hydroxybutyrate, KBR) in both arterial blood of the pigs with failed liver and hepatic vein of the auxiliary transplanted liver. We have found that arterial ketone bodies of th pigs are lower than those of men, rabbits, or rats.2. Partial hepatectomy model as a recipient. Initialy, we have tried to establish a liver failure model in 90% hepatectomized pig. However, a hemodynamically stable model could not be made mainly due to large blood loss. Auxiliary liver transplantation in this model resulted in decrease of KBR in both recipient and auxiliary liver. In this model, we have failed to evaluate the availability of KBR as an index of graft failure.3. Establishment of acute liver failure induced by liver ischemia in pigs with portacaval shunt. Acute liver failure was made by the clamping of the hepatic triads for 6 hours. During liver ischemia, the levels of transaminases, arterial ammonia, and potassium were increased gradually. PT and PTT were prolonged. During the hepatic triads clamping, the arterial ketone bodies were hardly detected. Within 2 hours after the declamping, arterial KBR was recovered temporally, but the ratio continued to decline. All pigs died within 8 hours after the declamping. It was suggested that by measuring the changes in arterial KBR in this model, the efficiency of metabolic support as provided by ex-vivo perfused liver or auxiliary transplanted liver could be assessed.4. Since auxiliary liver transplantation on this animal was found to be possible without large blood loss, we have begun to evaluate the availability of KBR as an index of graft failure in this model.