| Objective In this paper,fast reconstruction of rat SHVC completed via a new tool of self-developed magnetic ring greatly shortened anhepatic phase,and the rat orthotopic liver transplantation(ROLT)model with extremely short anhepatic phase(ESAP)was established firstly worldwide.Thus,the concept of extremely short anhepatic phase(ESAP)was raised for the fist time.Based on the clincial experience and technique,the paper will discuss and study the dual protective roles on the recipients and graft,and the interaction between recipient and graft to explore the meaning and value of ESAP,which would reveal the internal mechanism of the dual protective role to the recipients and grafts.Methods1.Self-developed titanium coating Nd Fe B magnetic ring was embedded in the intraperitoneal and obtain samples after 14 d,1m,3m and 6m respectively to observe by naked eye and examinate pathologically.Histological observation was carried out on the 4 aspects of the inflammation,the formation of fiber wall,surrounding tissue reaction and material degradation to evaluate the biocompatibility and rank the magnetic exposure risk.2.We took advantage of the magnetic ring to reconstruct SHVC of rat and compare the difference between the results with magnetic ring anastomosis and hand-stitched.Meanwhile we tested the rapid vascular anastomosis with magnetic ring,took the assessment of the anhepatic phase differences and the stability and practicality of the model.3.Based on the rat liver transplantation model with ESAP,we valuated the effects of ESAP to recipients and grafts through blood biochemistry,tissue pathology,liver electron microscopy,concentrations of cytokines at different time points by protein chip test techniques in blood and liver after reperfusion,to reveal the internal mechanism of interaction.Results1.Toxic free magnetic ring with even titanium coating resulted in a mild inflammatory response surrounding the magnetic ring which was disappeared after 6m.Due to the titanium coating magnetic is non-toxic and biologically inactive,a complete fibrous tissue was trigged,which wrapped the magnetic ring and the wall gradually turned thinner after operation,thus no magnetic degradation of corrosion was found with lighter surrounding tissue reaction in implanted rat peritoneal at the time of the 14 d and 6m due to the protection of the titanium coating.The oppression to the surrounding tissue was significantly reduced because of the thinner wall and the surrounding tissue atrophy did not appear again,which showed good biocompatibility,safety and reliability in local magnetic field strength and range.2.Taking advantage of the quick match with magnetic ring technology,the SHVC reconstruction of rat OLT model becomes more simple and quick.SHVC reconstruction time was reduced from 10.40 ± 2.11 minutes to 0.91 ± 0.24 minutes and the anhepatic phase decreased from 17.76 ± 2.51 minutes to 5.63 ± 0.65 minutes.In magnetic ring group,no thrombosis or hemorrhage was formed in anastomotic area,which was confirmed by pathology and scanning electron microscopy and healed well.The survival rate was 90% after 1 week,85% after 1 month postoperatively.3.Compared to normal anhepatic phase group,the ESAP group showed a stronger protective advantage for both the recipient and graft by alleviating ischemiareperfusion injury from the results of the analysis.Conclusion1.The structure of titanium coating magnetic ring for micro vascular anastomosis was designed rationally with good biocompatibility and the magnetic exposure intensity is far lower than the international safety standard.2.Taking advantage of the titanium coating ring for micro vascular anastomosis,SHVC was fast reconstructed successfully to achieve an extreme short anhepatic phase of 5min around in the rat liver transplantation.The model is simple,stable and reliable.3.ESAP is beneficial to recipients and grafts in rat liver transplantation with double protective effects,which mechanism is related to alleviating of ischemia-reperfusion injury via reducing the endotoxin release and shortening the warm ischemia time resulted in the reduction of the generation of inflammatory cytokines TNF-a,IL-1?,IL-6,IFN-? and chemotactic factor MCP-1 and adhesion molecule L-selectin,ICAM-1(inhibiting inflammatory cascade reaction). |
PDF Full Text Request