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：

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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.	黄洁夫. 推动我国器官移植事业健康发展的关键性举措——心死亡器官捐献试点工作原则性思考. 中华器官移植杂志, 2011, 32(1): 1-4.
2.	刘永锋. 心脏死亡供者器官评估及体外修复. 中华器官移植杂志, 2010, 31(7): 393-396.
3.	邓永林, 沈中阳. 我国心脏死亡器官捐献的现状及影响因素. 中华外科杂志, 2012, 50(8): 673-674.
4.	董权, 李超, 王胤佳, 等. 中国实行心脏死亡器官捐献供体的可行性分析. 中国普外基础与临床杂志, 2012, 19(5): 498-501.
5.	尹志科, 严谨. 心脏死亡器官捐献的困境及对策. 医学与哲学, 2012, 33(1): 28-29, 32.
6.	杨春华, 陈雪霞, 谢文锋, 等. 器官捐献与供体维护. 新医学, 2013, 44(6): 363-365.
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10.	陈志红, 钱海鑫, 秦磊, 等. 改良二套管法大鼠原位肝移植的围术期管理. 江苏大学学报(医学版), 2009, 19(4): 360-361, 365.
11.	张升宁, 李立, 冉江华, 等. 原位肝移植术中动脉重建及术后并发症的防治. 中国普外基础与临床杂志, 2007, 14(5): 564-568.
12.	刘骅, 曹晖, 吴志勇. 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, 叶启发, 等. 大鼠自体原位肝移植灌注模型的技术改良. 中国普通外科杂志, 2008, 17(7): 716-717.
14.	侍阳, 周晓俊, 殷骏, 等. 二袖套法大鼠原位肝移植50例. 徐州医学院学报, 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.	梁锐. 大鼠肝移植模型制作. 实用器官移植电子杂志, 2014, 2(1): 46.
17.	李立. 大鼠肝移植手术图谱. 北京: 人民卫生出版社, 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.	张华, 杨定华, 彭民浩. 改良" 二袖套法”大鼠原位肝移植及早期并发症预防. 中国现代手术学杂志, 2007, 11(4): 247-250.
20.	张国伟, 周杰, 赵宏峰, 等. 改良Kamada法大鼠肝移植并发症的常见因素及预防. 中国临床解剖学杂志, 2009, 27(3): 363-365.
21.	马毅, 何晓顺, 陈规划. 大鼠原位肝移植模型的手术技巧及并发症的预防. 中华显微外科杂志, 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. 黄洁夫. 推动我国器官移植事业健康发展的关键性举措——心死亡器官捐献试点工作原则性思考. 中华器官移植杂志, 2011, 32(1): 1-4.
2. 刘永锋. 心脏死亡供者器官评估及体外修复. 中华器官移植杂志, 2010, 31(7): 393-396.
3. 邓永林, 沈中阳. 我国心脏死亡器官捐献的现状及影响因素. 中华外科杂志, 2012, 50(8): 673-674.
4. 董权, 李超, 王胤佳, 等. 中国实行心脏死亡器官捐献供体的可行性分析. 中国普外基础与临床杂志, 2012, 19(5): 498-501.
5. 尹志科, 严谨. 心脏死亡器官捐献的困境及对策. 医学与哲学, 2012, 33(1): 28-29, 32.
6. 杨春华, 陈雪霞, 谢文锋, 等. 器官捐献与供体维护. 新医学, 2013, 44(6): 363-365.
7. 门贺伟, 蔡金贞. 心脏死亡供肝热缺血-损伤的研究进展. 国际移植与血液净化杂志, 2011, 09(4): 8-12.
8. 刘学民, 王博, 于良, 等. 心脏死亡供体经典原位肝移植的单中心临床研究. 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. 陈志红, 钱海鑫, 秦磊, 等. 改良二套管法大鼠原位肝移植的围术期管理. 江苏大学学报(医学版), 2009, 19(4): 360-361, 365.
11. 张升宁, 李立, 冉江华, 等. 原位肝移植术中动脉重建及术后并发症的防治. 中国普外基础与临床杂志, 2007, 14(5): 564-568.
12. 刘骅, 曹晖, 吴志勇. 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, 叶启发, 等. 大鼠自体原位肝移植灌注模型的技术改良. 中国普通外科杂志, 2008, 17(7): 716-717.
14. 侍阳, 周晓俊, 殷骏, 等. 二袖套法大鼠原位肝移植50例. 徐州医学院学报, 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. 梁锐. 大鼠肝移植模型制作. 实用器官移植电子杂志, 2014, 2(1): 46.
17. 李立. 大鼠肝移植手术图谱. 北京: 人民卫生出版社, 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. 张华, 杨定华, 彭民浩. 改良" 二袖套法”大鼠原位肝移植及早期并发症预防. 中国现代手术学杂志, 2007, 11(4): 247-250.
20. 张国伟, 周杰, 赵宏峰, 等. 改良Kamada法大鼠肝移植并发症的常见因素及预防. 中国临床解剖学杂志, 2009, 27(3): 363-365.
21. 马毅, 何晓顺, 陈规划. 大鼠原位肝移植模型的手术技巧及并发症的预防. 中华显微外科杂志, 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

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