Study on Reconstruction of the Hepatic Artery and Superior Mesenteric Artery Using a Cryopreserved Graft

肝动脉和上级肠系膜动脉的重建是肝胆外科的难点。本研究的目的是评估深低温保存动脉移植的可行性，并消除术中肝缺血.用程序冷冻机对Wister大鼠主动脉进行冷冻保存。在化脓性腹膜炎的条件下，使用显微外科技术将保存的主动脉移植到受体大鼠体内。组织学检查显示，移植主动脉无感染，移植后血管组织学变化正常，包括暂时性内皮细胞丢失和内膜增生.猪的肝动脉和上级肠系膜动脉由于淋巴管粗大，重建困难.大鼠肝缺血90 min后，分为C组（对照组）、U组（Urge-8）和F组（FK 506）。分别于再灌注后1小时和1周检测肝酶、pH、白细胞介素8（IL-8）和动脉血酮体比率（AKBR）。比较存活率。观察肝脏组织学损伤情况，ASD染色计数肝脏中性粒细胞浸润数。1周存活率C组（12/20）低于U组（16/20）和F组（15/19）。肝脏再灌注后1h，C组血清GOT、GPT、LDH、IL-8水平、肝脏中性粒细胞计数及肝脏损伤程度均高于U组和F组。移植后1周，这些变化大部分消退.虽然肝组织PO 2水平显示肝缺血的存在，但其与肝缺血损伤的程度无关。总之，本研究表明，在存在腹膜炎的情况下，冷冻保存动脉移植的安全性和神经抑制治疗肝缺血的有效性

Reconstruction of the hepatic artery and superior mesenteric artery is challenging in hepatobiliary surgery. The purpose of this study is to evaluate the feasibility of cryopreserved arterial grafting and to eliminate intraoperative hepatic ischemia during these procedures.1. The aorta of Wister rats was cryopreserved with a program-freezer. The preserved aorta was transplanted to a recipient rat using a microsurgical technique under the condition of purulent peritonitis. Histologically, the grafted aorta showed no infection and a normal process after cryopreserved arterial grafting, including temporary endothelial cell loss and intimal hyperplasia.2. Reconstruction of the hepatic artery and superior mesenteric artery of pigs was difficult because of thick lymphatic channels.3. Rats receiving 90-min hepatic ischemia were divided into group C (control), group U treated with Urge-8, an antineutrophil antibody andgroup F treated with FK506, an immunosuppressor. Liver enzymes, pH, interleukin-8 (IL-8), and arterial ketone body ratio (AKBR) were measured 1 hour and 1 week after hepatic reperfusion. Survival rates were compared. Histologic damages of the liver were studied and the number of hepatic neutrophil infiltration was counted using ASD staining. One week-survival rate was tended to be lower in group C (12/20) than in groups U (16/20) and F (15/19). One hour after reperfusion of the liver, levels of GOT, GPT, LDH, and IL-8, hepatic neutrophil counts, and degree of hepatic damages were higher in group C than in groups U and F. Most of these changes subsided 1 week after grafting.4. Although hepatic tissue PO2 levels showed the presence of hepatic ischemia, it did not correlate to the degree of hepatic ischemic injury.In conclusion, this study indicated the safety of cryopreserved arterial grafting in the presence of peritnitis and efficacy of netrophil suppression therapy for hepatic ischemia