The Experimental Study On Treatment Of Rat Acute Liver Injury With Auxiliary Partial Orthotopic Liver Transplantation

Part One Animal Model for Acute Liver InjuryObjectiveExplore a stable and reliable surgical animal model of acute liver injury.Methods50 male SD rats,weight 220-340 g,average 280±36g,randomly divided into the experimental group 40 and the control group 10.Control group was simple inhalation anesthesia then took cruciate abdominal incision and closed abdomen, would not do special treatment.Experimental group was divided into the group one and the experimental group two.The group one was inhalation anesthesia then took cruciate abdominal incision,revealed common bile duct and ligated with 1 silk,at the same time left lobe liver was resected.The group two was inhalation anesthesia then took cruciate abdominal incision,revealed common bile duct and ligated with 1 silk, then revealed hepatic artery and ligated with 1-0 silk,at the same time left lobe liver was resected.Postoperation,observation mental state,consumption,15-day survival rate.Animal was weight in 3,10,15 days and bleed to test liver function in time. Liver was cut to Pathological examination in 15 day.Using SPSS software,t test and multivariate analysis of variance. ResultsSD rats turned over in 3-5 minutes,watered in 2-4h,gradual return food, experiment group two after 15 days was tested serum alanine aminotransferase(ALT) 161±26U/L,serum albumin(ALB) 21±2g/L,serum total bilirubin(T-BIL) 326±53μmol/L,body weight 265±36g,The rats were killed 15 days and cut liver to Pathological examination.To find liver cell vary degrees injury,operative time is 5-20 minutes.Experiment group one after 15 days was tested serum alanine aminotransferase(ALT) 149±40U/L,serum albumin(ALB) 23±2g/L,serum total bilirubin(T-BIL) 326±67μmol/L,body weight 259±35g,The rats were killed 15 days and cut liver to Pathological examination.To find liver cell vary degrees injury, operative time is 5-20 minutes.Control group one after 15 days was tested serum alanine aminotransferase(ALT)40±5U/L,serum albumin(ALB) 34±2g/L,serum total bilirubin(T-BIL) 19±4μmol/L,body weight 287±41g,The rats were killed 15 days and cut liver to pathological examination.To find liver cell normal,operative time is 5-20 minutes.After 15 days,50 rats survive.By comparison,body weight and liver function and control groups was statistically significant(P＜0.05),experimental group one and an experimental group two was not statistically significant(P＞0.05).ConclusionsResection liver left lobe,bile duct ligation and hepatic artery ligation is the production of acute liver injury in animals,a good way of model. Part two The Experimental Study on Treatment of Rat Acute Liver Injury with Auxiliary Partial Orthotopic Liver TransplantationObjectiveExplore auxiliary partial orthotopic liver transplantation improve the situation that acute liver injury in rats.Methods60 male SD rats,weight 220-340 g,average 256±28g,randomly divided into the donor 30 and the receptors 30.Donor surgery:Donor 30 were continued inhalation anesthesia,laparotomy ibid,the mesenteric vein was injected saline containing 2mL heparin 150U,make the rats heparin,revealed common bile duct in the hilar,cut the anterior wall of common bile duct,implantated epidural catheter,about 4mm,ligatured and fixed in 1 silk,cut off distal common bile duct.Cut off perihepatic ligament,revealed blood vessels to ligated and cut off, revealed hepatic inferior vena cava.Blocked distal abdominal aorta,insertied trocar in the proximal,cut diaphragm,blocked thoracic aorta,cut intrathoracic inferior vena cava and Renal inferior vena cava.Put 4℃heparin balanced salt solution into the abdominal aorta,at the same time,leached liver,cut off liver until the end.Ligated and cut hepatic artery.Cut off the inferior vena cava import in the left renal vein and inferior vena cava above.Separated,ligated,cut off the portal vein,within cut off the diaphragm and chest inferior vena cava,removed the liver.Graft trim and casingLiver trimming the balance of fluid at 4℃conducted in ice bath.Pruned redundant diaphragm,hepatic inferior vena cava both sides were sewed each slit with a 8-0 needle.Protected the entire left hepatic vein and inferior vena cava.Cut off the inferior vena cava pipeline redundant at the entrance to close to the hepatic vein. Resected the right side of the liver,leaving only the left liver,careful ligated liver sections of the pipe to prevent bleeding and bile leakage.Reservated portal vein and common bile duct.Portal vein was inserted epidural catheter tube,diameter about 2mm,there were scratches on the casing to prevent slipping,liver and inferior vena cava to be ligated.Receptor SurgeryAbdominal Ibid,fully exposed liver,cut off the falciform ligament and left triangular ligament.experimental group two wer applicated,ligated common bile duct and hepatic artery,when the left lobe was resected,the left hepatic vein was remitted by vein occlusion clip,cut off the left hepatic vein in the liver,blood vessel cross-section on both sides was sewed with the 8-0 silk,remote ligation,proximal vascular clip.Cut off the hepatic artery and left hepatic duct,removed the left liver. The graft was placed in the left lobe.The donor liver sutured on both sides of superior and inferior vena cava with the receptor,the corresponding parts of the left hepatic vein ligation for traction suture with 8-0 vascular suture the posterior wall of the order of suture veins,anterior;the donor portal vein set into the receptor portal vein left branch,restore donor left hepatic blood supply;took donor bile duct into the pipeline that has been set home jejunum,purse-string suture,closed abdominal,after incubation,the gradual resumption of diet.Postoperation,observation mental state,consumption,15-day survival rate. Animal was weight in 3,10,15 days and blood to test liver function in time.Liver was cut to Pathological examination in 15 day.Using SPSS software,T test and multivariate analysis of variance.ResultsSD rats turned over in 3-5 minutes,watered in 2-4h,gradual return food.Donor operative time was 40-70 minutes,the receptor operative time was 35-80 minutes.30 cases liver transplantation rats,intraoperative death occurred was 3 cases,1 rat died anesthesia accidents,two rats died left hepatic vein bleeding.15-day survival rate was 74%(20/27).The recent cause of death was bleeding in 2 cases,air embolism in 1 case,long-term cause of death was intra-abdominal infection in 2 cases,the left portal vein thrombosis in 1 case,bile leakage in 1 case.after 15 days was tested serum alanine aminotransferase(ALT) 119±29U/L, serum albumin(ALB) 24±3g/L,serum total bilirubin(T-BIL) 217±35μmol/L, body weight 266±31g,The rats were killed 15 days and cut liver to Pathological examination.To find liver cell vary degrees regeneration.By comparison,body weight and liver function of experimental group two and receptor group were statistically significant(P＜0.05).ConclusionsResection liver left lobe,bile duct and hepatic artery were ligated and produced acute liver injury in animals,a good way of model and then proceed to auxiliary partial orthotopic liver transplantation(APOLT),the exact effect,better APOLT simulated clinical treatment of acute liver failure and found that liver cells of donor had different level renew,could significantly improve the receptor liver function, passed the critical stage,and also enrich the theory and practice in this area.