Experimental Research on Efficacy of Sequential Liver and Small intestinal transplantation

据报道，肝移植可诱导供体特异性耐受。活体相关肝移植耐受诱导后，同一供者小肠移植物可接受，无免疫抑制。在第一年和第二年，以猪为模型，建立了活体小肠种植的操作技术。取带血管蒂的回肠移植物约3 m，取白猪和黑猪2头。每条肠系膜上血管的切割位置均位于结肠最末端分支的远端。然后相互交换肠移植物，将移植物动脉与主动脉吻合，移植物静脉与下腔静脉端侧吻合。第三年，用应变计（S-G）力传感器监测接枝运动。S-G换能器固定在浆膜上。因此，MMC的三个参数，持续时间、振幅和间隔在排斥移植物中受损，而MMC在整个移植物中传播，在功能移植物中三个参数正常。我们得出结论，S-G方法可以实时监测移植肠道的运动，有助于检测小肠移植后的排斥反应。在第1年，将组织学结果与运动性研究进行比较。S-G法可检测组织学轻度排斥反应。先后肝小肠联合移植在大鼠模型上取得成功，但猪模型尚未建立。

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.