Analysis of early death causes following orthotopic liver transplantation using donation after cardiac death in rat_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HUANG Zhaoyu , WU Ruichao ,  RAN Jianghua , LIU Junhan

Department of Hepatobiliary Surgery, Affiliated Ganmei Hospital of Kunming Medical University (The First People’s Hospital of Kunming), Kunming 650011, P. R. China;

Corresponding?author：

RAN Jianghua, Email: rjh2u@163.com

Keywords：

rat; donation after cardiac death; orthotopic liver transplantation; death cause

DOI：

10.7507/1007-9424.201709042

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To establish a stable model of orthotopic liver transplantation (OLT) using donation after cardiac death (DCD) in rat, and to analyze death causes within 24 h after OLT, then explore appropriate treatment strategies for it. Methods The heart arrested 10 min before liver graft harvesting. The rat OLT model using DCD was performed by Kamada two-cuff technique. The operative time and death were recorded. Results One hundred OLT models using DCD were performed successfully within 40 d, the donor operative time was (20±5) min, the recepient operative time was (55±5) min, the anhepatic phase was (20±3) min. Nine rats were died during the operation, including 4 cases of massive haemorrhage, 1 case of anesthesia accident, 1 case of longer anhepatic phase, 1 case of sleeve implant failure, and 2 cases of aeroembolism. Twenty-two rats died within 12 h after the operation, including 6 cases of intestinal necrosis, 6 cases of anastomotic bleeding, 3 cases of pulmonary edema, 4 cases of intraoperative massive haemorrhage, 2 cases of vascular embolism, and 1 case of unexplained death. Nineteen rats died 12–24 h after the operation, including 9 cases of intestinal necrosis, 3 cases of anastomotic bleeding, 2 cases of pulmonary edema, 1 case of intraoperative massive haemorrhage, 1 case of vascular embolism, and 3 cases of unexplained death. Conclusions There are many reasons resulting in early death of rat OLT using DCD, postoperative intestinal necrosis, intraoperative and postoperative bleeding, and postoperative pulmonary edema are main causes. For these reasons, prevention and improvement measures are helpful to establish a stable model and improve a successful rate of rat OLT using DCD.

Citation： HUANG Zhaoyu, WU Ruichao, RAN Jianghua, LIU Junhan. Analysis of early death causes following orthotopic liver transplantation using donation after cardiac death in rat. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(3): 296-300. doi: 10.7507/1007-9424.201709042 Copy

1.	黃潔夫. 推動我國器官移植事業健康發展的關鍵性舉措——心死亡器官捐獻試點工作原則性思考. 中華器官移植雜志, 2011, 32(1): 1-4.
2.	劉永鋒. 心臟死亡供者器官評估及體外修復. 中華器官移植雜志, 2010, 31(7): 393-396.
3.	鄧永林, 沈中陽. 我國心臟死亡器官捐獻的現狀及影響因素. 中華外科雜志, 2012, 50(8): 673-674.
4.	董權, 李超, 王胤佳, 等. 中國實行心臟死亡器官捐獻供體的可行性分析. 中國普外基礎與臨床雜志, 2012, 19(5): 498-501.
5.	尹志科, 嚴謹. 心臟死亡器官捐獻的困境及對策. 醫學與哲學, 2012, 33(1): 28-29, 32.
6.	楊春華, 陳雪霞, 謝文鋒, 等. 器官捐獻與供體維護. 新醫學, 2013, 44(6): 363-365.
7.	門賀偉, 蔡金貞. 心臟死亡供肝熱缺血-損傷的研究進展. 國際移植與血液凈化雜志, 2011, 09(4): 8-12.
8.	劉學民, 王博, 于良, 等. 心臟死亡供體經典原位肝移植的單中心臨床研究. 器官移植, 2013, 4(1): 23-27.
9.	Ma Y, Wang GD, Wu LW, et al. Dynamical changing patterns of histological structure and ultrastructure of liver graft undergoing warm ischemia injury from non-heart-beating donor in rats. World J Gastroenterol, 2006, 12(30): 4902-4905.
10.	陳志紅, 錢海鑫, 秦磊, 等. 改良二套管法大鼠原位肝移植的圍術期管理. 江蘇大學學報(醫學版), 2009, 19(4): 360-361, 365.
11.	張升寧, 李立, 冉江華, 等. 原位肝移植術中動脈重建及術后并發癥的防治. 中國普外基礎與臨床雜志, 2007, 14(5): 564-568.
12.	劉驊, 曹暉, 吳志勇. 改良二袖套法大鼠原位肝移植180例. 消化外科, 2006, 5(1): 52-56.
13.	熊力, 王玉柱, 葉啟發, 等. 大鼠自體原位肝移植灌注模型的技術改良. 中國普通外科雜志, 2008, 17(7): 716-717.
14.	侍陽, 周曉俊, 殷駿, 等. 二袖套法大鼠原位肝移植50例. 徐州醫學院學報, 2007, 27(9): 588-591.
15.	Kamada N, Calne RY. A surgical experience with five hundred thirty liver transplants in the rat. Surgery, 1983, 93(1 Pt 1): 64-69.
16.	梁銳. 大鼠肝移植模型制作. 實用器官移植電子雜志, 2014, 2(1): 46.
17.	李立. 大鼠肝移植手術圖譜. 北京: 人民衛生出版社, 2012: 3.
18.	Kashfi A, Mehrabi A, Pahlavan PS, et al. A review of various techniques of orthotopic liver transplantation in the rat. Transplant Proc, 2005, 37(1): 185-188.
19.	張華, 楊定華, 彭民浩. 改良" 二袖套法”大鼠原位肝移植及早期并發癥預防. 中國現代手術學雜志, 2007, 11(4): 247-250.
20.	張國偉, 周杰, 趙宏峰, 等. 改良Kamada法大鼠肝移植并發癥的常見因素及預防. 中國臨床解剖學雜志, 2009, 27(3): 363-365.
21.	馬毅, 何曉順, 陳規劃. 大鼠原位肝移植模型的手術技巧及并發癥的預防. 中華顯微外科雜志, 2003, 26(1): 45-47.
22.	Aguirre-Avalos G, Covarrubias-Velasco MA, Rojas-Sánchez AG. Venous outflow obstruction and portopulmonary hypertension after orthotopic liver transplantation. Am J Case Rep, 2013, 14: 354-358.
23.	Matevossian E, Doll D, Hüser N, et al. Liver transplantation in the rat: single-center experience with technique, long-term survival, and functional and histologic findings. Transplant Proc, 2009, 41(6): 2631-2636.
24.	Ariyakhagorn V, Schmitz V, Olschewski P, et al. Improvement of microsurgical techniques in orthotopic rat liver transplantation. J Surg Res, 2009, 153(2): 332-339.

1. 黃潔夫. 推動我國器官移植事業健康發展的關鍵性舉措——心死亡器官捐獻試點工作原則性思考. 中華器官移植雜志, 2011, 32(1): 1-4.
2. 劉永鋒. 心臟死亡供者器官評估及體外修復. 中華器官移植雜志, 2010, 31(7): 393-396.
3. 鄧永林, 沈中陽. 我國心臟死亡器官捐獻的現狀及影響因素. 中華外科雜志, 2012, 50(8): 673-674.
4. 董權, 李超, 王胤佳, 等. 中國實行心臟死亡器官捐獻供體的可行性分析. 中國普外基礎與臨床雜志, 2012, 19(5): 498-501.
5. 尹志科, 嚴謹. 心臟死亡器官捐獻的困境及對策. 醫學與哲學, 2012, 33(1): 28-29, 32.
6. 楊春華, 陳雪霞, 謝文鋒, 等. 器官捐獻與供體維護. 新醫學, 2013, 44(6): 363-365.
7. 門賀偉, 蔡金貞. 心臟死亡供肝熱缺血-損傷的研究進展. 國際移植與血液凈化雜志, 2011, 09(4): 8-12.
8. 劉學民, 王博, 于良, 等. 心臟死亡供體經典原位肝移植的單中心臨床研究. 器官移植, 2013, 4(1): 23-27.
9. Ma Y, Wang GD, Wu LW, et al. Dynamical changing patterns of histological structure and ultrastructure of liver graft undergoing warm ischemia injury from non-heart-beating donor in rats. World J Gastroenterol, 2006, 12(30): 4902-4905.
10. 陳志紅, 錢海鑫, 秦磊, 等. 改良二套管法大鼠原位肝移植的圍術期管理. 江蘇大學學報(醫學版), 2009, 19(4): 360-361, 365.
11. 張升寧, 李立, 冉江華, 等. 原位肝移植術中動脈重建及術后并發癥的防治. 中國普外基礎與臨床雜志, 2007, 14(5): 564-568.
12. 劉驊, 曹暉, 吳志勇. 改良二袖套法大鼠原位肝移植180例. 消化外科, 2006, 5(1): 52-56.
13. 熊力, 王玉柱, 葉啟發, 等. 大鼠自體原位肝移植灌注模型的技術改良. 中國普通外科雜志, 2008, 17(7): 716-717.
14. 侍陽, 周曉俊, 殷駿, 等. 二袖套法大鼠原位肝移植50例. 徐州醫學院學報, 2007, 27(9): 588-591.
15. Kamada N, Calne RY. A surgical experience with five hundred thirty liver transplants in the rat. Surgery, 1983, 93(1 Pt 1): 64-69.
16. 梁銳. 大鼠肝移植模型制作. 實用器官移植電子雜志, 2014, 2(1): 46.
17. 李立. 大鼠肝移植手術圖譜. 北京: 人民衛生出版社, 2012: 3.
18. Kashfi A, Mehrabi A, Pahlavan PS, et al. A review of various techniques of orthotopic liver transplantation in the rat. Transplant Proc, 2005, 37(1): 185-188.
19. 張華, 楊定華, 彭民浩. 改良" 二袖套法”大鼠原位肝移植及早期并發癥預防. 中國現代手術學雜志, 2007, 11(4): 247-250.
20. 張國偉, 周杰, 趙宏峰, 等. 改良Kamada法大鼠肝移植并發癥的常見因素及預防. 中國臨床解剖學雜志, 2009, 27(3): 363-365.
21. 馬毅, 何曉順, 陳規劃. 大鼠原位肝移植模型的手術技巧及并發癥的預防. 中華顯微外科雜志, 2003, 26(1): 45-47.
22. Aguirre-Avalos G, Covarrubias-Velasco MA, Rojas-Sánchez AG. Venous outflow obstruction and portopulmonary hypertension after orthotopic liver transplantation. Am J Case Rep, 2013, 14: 354-358.
23. Matevossian E, Doll D, Hüser N, et al. Liver transplantation in the rat: single-center experience with technique, long-term survival, and functional and histologic findings. Transplant Proc, 2009, 41(6): 2631-2636.
24. Ariyakhagorn V, Schmitz V, Olschewski P, et al. Improvement of microsurgical techniques in orthotopic rat liver transplantation. J Surg Res, 2009, 153(2): 332-339.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of early death causes following orthotopic liver transplantation using donation after cardiac death in rat

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content