Name: heterotopic auxiliary rat liver transplantation with flow-regulated portal vein arterialization in acute hepatic failure
Uploaded: 2014-09-13T14:00:00
Description: Watch this Scientific Journal Video about Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure at JoVE.com

这项研究经费由“德意志研究联合会”（DFG）。 K. Schleimer是由国家科技部的莉泽·迈特纳北威州奖学金和研究支持。我们要感谢夫人玛丽 - 琼Blümich为她优秀的编辑协助。玛丽亚Kokozidou博士从费森尤斯2011_A61资金。

1，实验动物<ol><li>获得了将要执行的，依照动物保护FELASA指引所有实验当地伦理委员会的批准（K 40，17/99）。 </li><li>用雄性Lewis大鼠可从任何商业育种（ 如查尔斯河Wiga有限公司，的Sulzfeld，德国）购买。这里，224只动物（112供体，112的收件人）被用来执行112移植。处死术后6周收件人。在操作时，将动物应权衡250-350克。 </li><li>请在空调房的动物免费获得食物和水。 </li></ol><p class="jove_titl...

<ol>
	<li>Boudjema, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Auxiliary+liver+transplantation+for+fulminant+and+subfulminant+hepatic+failure.">Auxiliary liver transplantation for fulminant and subfulminant hepatic failure.</a> Transplantation. 59, 218-223 (1995).</li><li>Boudjema, K., Jaeck, D., Sim&#233;oni, U., Bientz, J., Chenard, M. P., Brunot, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Temporary+auxiliary+liver+transplantation+for+subacute+liver+failure+in+a+child.">Temporary auxiliary liver transplantation for subacute liver failure in a child.</a> The Lancet. 342, 778-779 (1993).</li><li>Chenard-Neu, M. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Auxiliary+liver+transplantation:+Regeneration+of+the+native+liver+and+outcome+in+30+patients+with+fulminant+hepatic+failure+-+a+multicenter+European+study.">Auxiliary liver transplantation: Regeneration of the native liver and outcome in 30 patients with fulminant hepatic failure - a multicenter European study.</a> Hepatology. 23, 1119-1127 (1996).</li><li>Gubernatis, G., Pichlmayr, R., Kemnitz, J., Gratz, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Auxiliary+partial+orthotopic+liver&#8211;transplantation+(APOLT)+for+fulminant+hepatic+failure:+first+successful+case+report.">Auxiliary partial orthotopic liver&#8211;transplantation (APOLT) for fulminant hepatic failure: first successful case report.</a> World J Surg. 15, 660-666 (1991).</li><li>Erhard, J., Lange, R., Giebler, R., Rauen, U., de Groot, H., Eigler, F. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Arterialization+of+the+portal+vein+in+orthotopic+and+auxiliary+liver+transplantation.">Arterialization of the portal vein in orthotopic and auxiliary liver transplantation.</a> Transplantation. 60, 877-879 (1995).</li><li>Erhard, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Auxiliary+liver+transplantation+with+arterialization+of+the+portal+vein+for+acute+hepatic+failure.">Auxiliary liver transplantation with arterialization of the portal vein for acute hepatic failure.</a> Transpl Int. 11, 266-271 (1998).</li><li>Emond, J., Capron-Laudereau, M., Meriggi, F., Bernuau, J., Reynes, M., Houssin, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Extent+of+Hepatectomy+in+the+rat.">Extent of Hepatectomy in the rat.</a> Eur Surg Res. 21, 251-259 (1989).</li><li>Mas, A., Rode`s, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fulminant+hepatic+failure.">Fulminant hepatic failure.</a> Lancet. 349, 1081-1085 (1997).</li><li>Terpstra, O. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Auxiliary+liver+grafting:+a+new+concept+in+liver+transplantation.">Auxiliary liver grafting: a new concept in liver transplantation.</a> The Lancet. 342, 758 (1993).</li><li>Terpstra, O. T., Reuvers, C. B., Schalm, S. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Auxiliary+heterotopic+liver+transplantation.">Auxiliary heterotopic liver transplantation.</a> Transplantation. 45, 1003-1007 (1988).</li><li>Schleimer, K., Lange, R., Rauen, U., Erhard, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Auxiliary+liver+transplantation+in+acute+liver+failure+in+the+rat+-+an+illustrated+description+of+a+new+surgical+approach.">Auxiliary liver transplantation in acute liver failure in the rat - an illustrated description of a new surgical approach.</a> Langenbecks Arch Surg. 384 (2), 204-208 (1999).</li><li>Schleimer, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Physiologic+microcirculation+of+the+heterotopically+transplanted+rat+liver+with+portal+vein+arterialization+depending+on+optimal+stent+diameter.">Physiologic microcirculation of the heterotopically transplanted rat liver with portal vein arterialization depending on optimal stent diameter.</a> Med Sci Monit. 28 (BR140-145), (2006).</li><li>Hong, H. Q., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Study+of+portal+arterialization+with+auxiliary+liver+in+rats.">Study of portal arterialization with auxiliary liver in rats.</a> Hiroshima J. Med. Sci. 40, 29-33 (1991).</li><li>Higgins, G. M., Anderson, R. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Experimental+pathology+of+the+liver.+I--Restoration+of+the+liver+of+the+white+rat+following+partial+surgical+removal.">Experimental pathology of the liver. I--Restoration of the liver of the white rat following partial surgical removal.</a> Arch. Path. 12, 186-202 (1931).</li><li>Schleimer, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Auxiliary+liver+transplantation+with+flow-regulated+portal+vein+arterialization+offers+a+successful+therapeutic+option+in+acute+hepatic+failure--investigations+in+heterotopic+auxiliary+rat+liver+transplantation.">Auxiliary liver transplantation with flow-regulated portal vein arterialization offers a successful therapeutic option in acute hepatic failure--investigations in heterotopic auxiliary rat liver transplantation.</a> Transpl Int. 19 (7), 581-588 (2006).</li><li>Lee, S., Edgington, T. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Liver+transplantation+in+the+rat.">Liver transplantation in the rat.</a> Surg. Forum. 17, 220-222 (1966).</li><li>Hess, F., Willemen, A., Jerusalem, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Auxiliary+liver+transplantation+in+the+rat,+influence+of+the+condition+of+the+recipient's+liver+on+the+fate+of+the+graft.">Auxiliary liver transplantation in the rat, influence of the condition of the recipient's liver on the fate of the graft.</a> Eur. Surg. Res. 9, 270-279 (1977).</li><li>Aguirrezabalaga, J., Arnal, F., Marini, M., Centeno, A., Fernandez-Selles, C., Rey, I., Gomez, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Auxiliary+liver+transplantation+with+portal+arterialization+in+the+rat:+description+of+a+new+model.">Auxiliary liver transplantation with portal arterialization in the rat: description of a new model.</a> Microsurgery. 22, 21-26 (2002).</li><li>Palmes, D., Dietl, K. H., Drews, G., Holzen, J. P., Spiegel, H. U. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Auxiliary+partial+orthotopic+liver+transplantation:+treatment+of+acute+liver+failure+in+a+new+rat+model.">Auxiliary partial orthotopic liver transplantation: treatment of acute liver failure in a new rat model.</a> Langenbecks Arch Surg. (386), 534-541 (2002).</li><li>Schleimer, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Improved+microcirculation+of+a+liver+graft+by+controlled+portal+vein+arterialization.">Improved microcirculation of a liver graft by controlled portal vein arterialization.</a> J Surg Res. 116 (2), 202-210 (2004).</li><li>Schleimer, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Portal+hyperperfusion+causes+disturbance+of+microcirculation+and+increased+rate+of+hepatocellular+apoptosis:+investigations+in+heterotopic+rat+liver+transplantation+with+portal+vein+arterialization.">Portal hyperperfusion causes disturbance of microcirculation and increased rate of hepatocellular apoptosis: investigations in heterotopic rat liver transplantation with portal vein arterialization.</a> Transplant Proc. 38 (3), 725-729 (2006).</li></ol>

第一异位辅助大鼠肝移植是由Lee 等人所描述的，在1966年16接着赫斯。移植物17中的门静脉吻合与接受者的门静脉。在此过程中，门静脉血液供应天然肝脏受到损害。 1991年，香港通过收件人的髂内动脉进行暂停与PVA的13无血流调节大规模门户网站和血窦拥塞的发生。 此外Aguirrezabalaga 等 ，进行暂停与PVA，但没有...

急性肝功能衰竭造成临床医学的一个严重问题，导致死亡率为60％-80％。8在急性肝功能衰竭，辅助肝移植是一种很有前途的替代疗法来弥补急性期。原生肝左再生和下面的再生免疫抑制药物可停药。作为结果，移植将成为萎缩。然而，手术技术辅助肝移植仍然是讨论。1-3在此背景下，特普斯特拉报空间不足的移植，门脉血盗血现象和静脉淤血和排水的问题。9-10捐赠者的门静脉吻合的端至端向接收方的门静脉。这导致在接枝和天然肝之间和在门静脉血栓形成门脉血流竞争。大多数的这些技术问题，可避免与使用APOLT-法（orthotopIC辅助段植入）。4但是这种方法需要两个原生肝移植。4在1998年广泛切除，艾哈德和他的团队开发了异位辅助肝移植（暂停）利用门静脉动脉聚乙烯醇（PVA）（ 图1 ）。肺门和本地肝脏的门静脉受到尊重与使用这种方法。 ，不遗余力，从不必要的副作用，如门静脉血栓形成和门脉血收件人盗取的现象，这可能会扰乱当地的肝脏恢复。此外，还需要对这个方法的原生肝移植无肝广泛切除，因而具有出血少，更其余全肝实质质量桥接（移植）和再生（原生肝）。这种技术表现出乐观的初步临床结果。5-6本实验工作的目标是暂停技术与门静脉动脉化发展大鼠用于研究目的（ 图2）。在初步实验中，我们并没有考虑到动脉化门静脉血流调节静脉，导致再灌注损伤和大出血的肝包膜充血后移植移植11此后在动脉化门静脉血流办法，由支架为0.3mm，内径为8毫米的长度。试点试验已经表明，在0.3毫米的支架直径得到的平均血流在动脉化门静脉即上部生理范围内（1.7±0.4毫升/分钟/克肝脏重量）12我们没有血流调节的结果与香港，谁通过收件人的髂内动脉进行暂停与PVA的13在他的实验中，没有血流调节大量的门户网站和正弦波发生拥塞的结果相关。 我们的视频的目的是与demonstrate步步这个ne.w实验外科技术在大鼠。在长期的提出的技术可以在肝脏再生和跨肝脏的竞争和门静脉动脉，门静脉高灌注及门脉血流调控研究中使用。

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heterotopic auxiliary rat liver transplantation with flow-regulated portal vein arterialization in acute hepatic failure

在急性肝功能衰竭的辅助肝移植是一个有趣的替代方法。其目的在于，提供一种临时支撑，直到发生故障的原生肝已再生。1-3 APOLT法，辅助segments-的原位移植可避免出现最多的技术问题。然而此方法需要两个天然肝和接枝。4在1998年广泛切除，艾哈德开发的异位辅助肝移植（HALT）利用门静脉动脉（PVA）（图1）。该技术表现出有前途的初步临床结果。5-6，我们开发出了HALT-技术与流量调节的PVA在大鼠研究流动调节PVA的上接枝形态和功能（图2）的影响。 一种肝移植缩小到原始大小的30％，是右肾外植后异位植入接受者的右侧肾区。60;移植物的红外肝腔静脉吻合与接受者的肝下腔静脉。捐赠者的门静脉动脉化进行了通过收件人的右肾动脉支架技术。动脉化门静脉的血流量的调节是通过使用一个支架上以0.3mm的内部直径来实现。移植物的腹腔干为端 - 侧吻合用收件人的主动脉和胆管被植入到十二指肠。执行了次全切除原生肝诱发急性肝功能衰竭。7 以这种方式112移植被执行。围手术期的存活率为90％和6周的存活率为80％。术后6周，天然肝再生，表示重量的增加，从2.3±0.8克至9.8±1克此时，接枝的重量从3.3±0.8克下降至2.3±0.8克</p&gt; 我们能够在接枝形态和功能的角度，以获得希望的长期结果。暂停与流量调节PVA的可靠桥梁急性肝功能衰竭，直至原生的肝脏再生。

移植的平均时间约为150分钟。冷缺血时间为64±7分钟时，热缺血时间为小于25分钟。 围手术期的存活率为90％和6周的存活率为80％。在术后第一周的20％的损失是由于因支架错位和胆漏（4只）腹膜炎，由于在接下来的5周肺炎，腹腔内脓肿及肠梗阻（7只）。幸存的动物们在良好的一般状况。 肝脏合成的参数（连结值：110±7.8％，AT III：104±6％）操作六周后?...

Watch this Scientific Journal Video about Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure at JoVE.com

Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure

辅助性肝移植提供了急性肝功能衰竭的临时支撑，直到失败的肝脏再生。异位辅助肝移植（HALT）与门静脉动脉聚乙烯醇（PVA）呈现足够的肝功能。我们开发了一种类似的方法在大鼠中，以检查对移植物的形态和功能的门静脉动脉化的影响。

在急性肝衰竭异位辅助性大鼠肝移植流量调节门静脉动脉

In acute hepatic failure auxiliary liver transplantation is an interesting alternative approach. The aim is to provide a temporary support until the ...

Research

JoVE Journal

Medicine

Orthotopic Liver Transplantation in Rats

大鼠原位肝移植

Clinical progress in the field of liver transplantation has been largely supported by animal models1,2. Since the publication of the first orthotopic rat ...

科研

医学

Surgical Procedures for a Rat Model of Partial Orthotopic Liver Transplantation with Hepatic Arterial Reconstruction

部分原位肝移植大鼠模型的肝动脉重建的外科手术

Orthotopic liver transplantation (OLT) in rats using a whole or partial graft is an indispensable experimental model for transplantation research, such as ...

Murine Heterotopic Heart Transplant Technique

小鼠异位心脏移植技术

It is now over forty years since this technique was first reported by Corry, Wynn and Russell. Although it took some years for other labs to become ...

Rat Heterotopic Abdominal Heart/Single-lung Transplantation in a Volume-loaded Configuration

大鼠异位心脏腹部/在卷装配置单肺移植

Herein, we describe a novel technique for heterotopic abdominal heart-lung transplantation (HAHLT) in rats. The configuration of the transplant graft ...

Heterotopic Cervical Heart Transplantation in Mice

颈椎异位心脏移植小鼠

The heterotopic cervical heart transplantation in mice is a valuable tool in transplant and cardiovascular research. The cuff technique greatly simplifies ...

Method of Direct Segmental Intra-hepatic Delivery Using a Rat Liver Hilar Clamp Model

直接节段性肝内交付使用大鼠肝门部夹具模型方法

Major hepatic surgery with inflow occlusion, and liver transplantation, necessitate a period of warm ischemia, and a period of reperfusion leading to ...

Rat Model of the Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) Procedure

Rat Model of the Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy ALPPS Procedure

肝分型与门静脉结扎大鼠分期肝切除 (ALPPS) 手术模型的建立

Recent clinical data support an aggressive surgical approach to both primary and metastatic liver tumors. For some indications, like colorectal liver ...

Re-Arterialized Rat Partial Liver Transplantation with an in vivo Vessel-Oriented 70% Hepatectomy

Re-Arterialized Rat Partial Liver Transplantation with an in vivo Vessel-Oriented 70% Hepatectomy

静脉大鼠部分肝移植的体内血管定向70% 肝切除术

Split liver transplantation and living liver donor liver transplantation were developed in the clinic to utilize liver organs in a more efficient manner. ...

Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats

肝硬化大鼠门脉高压综合征的侵袭性血流动力学特征

This is a detailed protocol describing invasive hemodynamic measurements in cirrhotic rats for the characterization of portal hypertensive syndrome. ...