目的探讨建立一种稳定、操作性好的大鼠原位肾移植模型的外科技术及其改进方法。方法用4℃肝素生理盐水原位灌注供肾,手术显微镜下行供肾动脉、静脉、输尿管与受鼠同名血管及输尿管端端吻合。受鼠双侧肾脏一起切除,建立大鼠左侧原位肾移植模型。结果经过技术改进,建立了稳定、易行的适合器官移植免疫学研究所需的大鼠单侧原位肾移植模型,模型成功率可达80%以上。对已完成的10对大鼠移植时间进行统计,完成1对大鼠肾移植需要(211.00±13.24)分钟,其中供肾切取(87.00±5.34)分钟,供肾移植(120.00±7.90)分钟;供肾移植中原肾脏切除(27.00±1.12)分钟,动脉吻合(35.00±1.98)分钟,静脉吻合(36.00±3.26)分钟,输尿管吻合(22.00±1.54)分钟。供肾热缺血时间为30秒,肾脏冷缺血时间为100分钟。10对原位肾移植大鼠中8对大鼠存活时间大于3天,移植肾形态、功能良好,其余2对大鼠死亡原因包括吻合口出血、血栓形成、尿漏等。结论本文所述方法和改进技巧有利于建立一种稳定的、适用于器官移植免疫学研究的大鼠原位肾移植模型。
Objective To investigate the procedure improvement of building a stable and operational orthotopic renal transplantation model in rats. Methods The left kidney was removed from the donor rat after perfusing it with ice-cold heparinized saline through the abdominal aorta. The donor kidney was transplanted orthotopically into a bilaterally nephrectomized recipient by end-to-end anastomosis of the left renal vessels and the left ureter using microsurgical technique. Results According to the improved procedure,a stable and easily operational renal transplantation model was set up with a success rate above 80%. 10 pairs of rats have received renal transplantation surgeries till now. The mean total surgery time was(211.00±13.24)minutes,with donor nephrectomy of(87.00±5.34)minutes and renal transplantation of(120.00±7.90)minutes. During the transplantation surgery, the time of nephrectomies was(27.00±1.12)minutes,with artery anastomosis of(35.00±1.98)minutes,vein anastomosis of(36.00±3.26)minutes,and ureteroureterostomy of(22.00±1.54)minutes. The mean warm ischemia time was 30 seconds,and the mean cold ischemia time was 100 minutes. 3-day survival rate was 80%with good graft function. 2 recipients died of anastomotic bleeding,thrombosis,urine leakage,and so on. Conclusion With the procedure improvement,it was very helpful to set up a stable and operational rat renal transplantation model for immunological researches.