The Influence Of Hypoxia Precondition On Intestinal Mucous Membrane Barrier In Autologous Orthotopic Liver Transplantation Rat

【Objective】:This thesis is based on the rat model of autologous orthotopic liver transplantation, on the basis of preoperative rats given hypoxic preconditioning (hypoxic preconditioning, HP), to investigate the influence of hypoxic preconditioning on intestinal mucosal barrier in the course of the liver transplantation.【Method】:1.SD rats were randomly assigned into three groups,Group A: hypoxic preconditioning transplantation group(n=50);Group B:autologous orthotopic liver transplantation group(n=50);Group C:sham-operated group(n=8).2.Autologous orthotopic liver transplantation model has been established.3.When the operation were successfully and reperfused for different times, liver samples and intestina parva were obtained from different experiment groups. The MDA in jejunum of rats were analyzed after liver transplantation in rats. The hepatic function was demonstrated by the level of serum ALB, TBIL, ALT, AST, and ALP.The MDA were determined in serum of recipients after liver transplantation as well.The morphological change of caudate lobe of liver and intestinal epithelial basement membrane were oberserved by optics microscopy and transmission electron microscopy, analyzed by MiVnt image analysis system.【Results】:1.After the operation, the recipient is able to maintain steady respiration and heartbeat, revive and turn over. Effective cases for 50 each in Group A and Group B, anhepatic phase (20±2.2 min), there was no significant difference (P>0.05). After one week, group A were 90.0% (9/10) survival and group B 80.0%(8/10), there was a statistically significant difference (P<0.01).2.Group A, Group B intestinal mucosa was observed under optics microscopy: intestinal tissue pathology score, the pathological changes of the intestinal mucosa results shows that,the intestinal mucosal injury were relieved in group A than in group B postoperation in corresponding periods, there was a statistically significant difference (P<0.05).3.The expression of HIF-1αin intestinal increased both in group A and group B, the expression remained at a relatively high level 24h postoperation,and there was a decreased trend 48h postoperation.The number of IgA plasma cells in group B is less than group A 24h postoperation,there is a significant difference 48h postoperation(P <0.05)4.The mitochondrial structural were integrity and its cristae were clear after operation in group A,the mitochondrial cristae were ambiguity, even to vanish, interstitial substance vacuolization and density degrade. Cell junction were compact in group A when its chalasia and ambiguity in group B after operation.5.Hepatic function in serum showed:ALT,AST in group A and B were significantly higher than group C, there was a statistically significant difference (P<0.05). ALT,AST in group A significantly lower than in group B compared to the corresponding period postoperation, there was a statistically significant difference (P<0.05). TBIL in group A were lower than group B, there was a statistically significant difference (P<0.05).MDA content in group A and B were significantly lower than group C, there was a statistically significant difference (P<0.05). MDA content in group A were significantly lower than group C, there was a statistically significant difference (P<0.05).【conclusion】 This investigation implied that recipient hypoxic preconditioning may relieve rat intestinal mucosa injury induced by intestinal stagnant anoxia in anhepatic phase and liver early-stage ischemia reperfusion injury during liver transplantation course. Hypoxic preconditioning mitigated hypoxia/reoxygenation-induced intestinal injury and protect intestinal mucosa barrier function,so that it can improve the hepatic function and prolong the rats survival postoperation.Hypoxic preconditioning on recipient may provide a novel approach to protecting the reperfusion injury of liver transplanted and decreasing the rate of liver no function in postoperation.