小鼠异位心脏移植模型的改良

目的探讨小鼠心脏移植模型的建立与改良。方法供体采用BLAB／c小鼠,受体采用C57小鼠。用24GACuff管法套扎供心肺动脉与颈外静脉,用自制Cuff管套扎供心升主动脉与颈总动脉。结果供心冷缺血时间少于15min,手术时间大大缩短,成功率明显提高。结论改进后的模型显著降低了手术难度,可用于移植免疫的各种研究。     

Heterotopic Cervical Heart Transplantation in Mice

The heterotopic cervical heart transplantation in mice is a valuable tool in transplant and cardiovascular research. The cuff technique greatly simplifies this model by avoiding challenging suture anastomoses of small vessels thereby reducing warm ischemia time. In comparison to abdominal graft implantation the cervical model is less invasive and the implanted graft is easily accessible for further follow-up examinations. Anastomoses are performed by pulling the ascending aorta of the graft over the cuff with the recipient’s common carotid artery and by pulling the main pulmonary artery over the cuff with the external jugular vein. Selection of appropriate cuff size and complete mobilization of the vessels are important for successful revascularization. Ischemia-reperfusion (I/R) injury can be minimized by perfusing the graft with a cardioplegic solution and by hypothermia. In this article, we provide technical details for a simplified and improved cuff technique, which should allow surgeons with basic microsurgical skills to perform the procedure with a high success rate.     

近交系小鼠不同品系颈部心脏移植

目的:建立近交系小鼠同种异品系颈部心脏移植模型.方法:用袖套法进行小鼠颈部心脏移植,选BALB/c小鼠(供体)和用C57小鼠(受体),进行同种异品系移植25例.结果:供心热缺血2～5 min,冷缺血20～25 min,手术总时间为60～70 min,手术成功率为96%.移植心脏平均存活期为(8.44±1.25)d,n=12.结论:运用改进的套管技术建立小鼠颈部心脏移植模型是一种成功率高而且可靠的方法,可用于移植免疫方面的研究.     

Murine Cervical Heart Transplantation Model Using a Modified Cuff Technique

Mouse models are of special interest in research since a wide variety of monoclonal antibodies and commercially defined inbred and knockout strains are available to perform mechanistic in vivo studies. While heart transplantation models using a suture technique were first successfully developed in rats, the translation into an equally widespread used murine equivalent was never achieved due the technical complexity of the microsurgical procedure. In contrast, non-suture cuff techniques, also developed initially in rats, were successfully adapted for use in mice^1-3. This technique for revascularization involves two major steps I) everting the recipient vessel over a polyethylene cuff; II) pulling the donor vessel over the formerly everted recipient vessel and holding it in place with a circumferential tie. This ensures a continuity of the endothelial layer, short operating time and very high patency rates⁴.Using this technique for vascular anastomosis we performed more than 1,000 cervical heart transplants with an overall success rate of 95%. For arterial inflow the common carotid artery and the proximal aortic arch were anastomosed resulting in a retrograde perfusion of the transplanted heart. For venous drainage the pulmonary artery of the graft was anastomosed with the external jugular vein of the recipient⁵.Herein, we provide additional details of this technique to supplement the video.     

大鼠腹腔异位心脏移植模型建立及改进

目的:建立一种快速有效的大鼠腹腔异位心脏移植模型。方法:采用SD大鼠作为受体,Wistar大鼠作为供体,行同种异位腹腔心脏移植,术后给以CsA5 mg/kg/d灌服,心脏移植手术方法采用改良的Ono术式,观察改良的腹腔异位心脏移植各步骤所需时间、术后成功率及主要并发症发生率。结果:共建立40只大鼠异位心脏移植模型,手术成功率92.5%。动脉吻合时间12.5±2.3min,静脉吻合时间12.3±1.5 min,供心缺血时间37±3.5 min,受体血管阻断时间34.2±2.6 min,总手术时间90.2±4.8 min,出现的主要并发症为出血和供心复跳失败(各占5%、2.5%)。结论:改进的大鼠腹部异位心脏移植技术是一种简便、快速、有效、成功率高的模型制作方法。     

两种异位心脏移植小鼠模型的建立和比较

目的比较腹部和颈部小鼠心脏移植模型的优缺点,探讨二次器官移植或双心脏移植研究的可行性和实用性动物模型。方法参照Ono法和Chen法并加以改进,建立了同系或者同种小鼠腹部和颈部异位心脏移植模型,同时对两种手术方式的成功率、手术时间、移植心脏存活时间和病理组织学进行了比较。结果腹部和颈部异位心脏移植手术成功率分别为86.7%和83.3%,两种手术方式在总手术时间、移植心脏存活时间和病理组织形态学检查上均无明显差异(P0.05)。结论在熟练掌握显微外科技术的基础上,两种异位心脏移植模型都能顺利建立,两者既可分开选用,又可结合运用,以适应不同实验需求。     

Orthotopic Kidney Transplantation in Mice: Technique Using Cuff for Renal Vein Anastomosis

Mouse renal transplantation is a technically challenging procedure. Although the first kidney transplants in mice were performed over 34 years ago and refined some years later, the classical techniques of mouse renal transplantation required clamping both vena cava and aorta simultaneously and carry out suture anastomoses of the renal artery and vein in a heterotopic position. In our laboratory, we have successfully developed mouse orthotopic kidney transplantation for the first time, using a rapid “cuffed” renal vein technique for vessel anastomosis, wherein the donor’s renal vein was inserted through an intravenous catheter, folded back and tied. During grafting, the cuffed renal vein was directly inserted into the recipient’s renal vein without the need for the clamping vena cava and suturing of renal vein. This technique allowed for the exact transplantation of the kidney into the original position, compared to the classical technique, and has significantly shortened the clamping time due to a quicker and precise anastomosis of renal vein as described. This also allowed for a quicker recovery of the lower extremity activity, reduction in myoglobinuria with resultant kidney graft survival of 88.9%. Thus we believe that the cuffed renal vein technique simplifies microvascular anastomoses and affords important additional benefits.     

Transplantation of Pulmonary Valve Using a Mouse Model of Heterotopic Heart Transplantation

Tissue engineered heart valves, especially decellularized valves, are starting to gain momentum in clinical use of reconstructive surgery with mixed results. However, the cellular and molecular mechanisms of the neotissue development, valve thickening, and stenosis development are not researched extensively. To answer the above questions, we developed a murine heterotopic heart valve transplantation model. A heart valve was harvested from a valve donor mouse and transplanted to a heart donor mouse. The heart with a new valve was transplanted heterotopically to a recipient mouse. The transplanted heart showed its own heartbeat, independent of the recipient’s heartbeat. The blood flow was quantified using a high frequency ultrasound system with a pulsed wave Doppler. The flow through the implanted pulmonary valve showed forward flow with minimal regurgitation and the peak flow was close to 100 mm/sec. This murine model of heart valve transplantation is highly versatile, so it can be modified and adapted to provide different hemodynamic environments and/or can be used with various transgenic mice to study neotissue development in a tissue engineered heart valve.     

小鼠腹部心脏移植模型的制作与改进

目的建立并改进小鼠腹部异位心脏移植模型,为器官移植研究提供技术支持。方法SPF级近交系小鼠112只进行心脏移植手术,在传统方法的基础上进行改进,观察改进后手术效果并分析其优势。结果手术成功率为89.28％。总手术时间（103.9±16.5）min,受体手术时间（73.0±7.9）min。改进的方法简化了操作步骤,降低了手术难度。结论改进的小鼠腹部异位心脏移植技术是一种简便、有效、成功率高的模型制作方法。     

Orthotopic Small Bowel Transplantation in Rats

Small bowel transplantation has become an accepted clinical option for patients with short gut syndrome and failure of parenteral nutrition (irreversible intestinal failure). In specialized centers improved operative and managing strategies have led to excellent short- and intermediate term patient and graft survival while providing high quality of life ^1,3. Unlike in the more common transplantation of other solid organs (i.e. heart, liver) many underlying mechanisms of graft function and immunologic alterations induced by intestinal transplantation are not entirely known^6,7. Episodes of acute rejection, sepsis and chronic graft failure are the main obstacles still contributing to less favorable long term outcome and hindering a more widespread employment of the procedure despite a growing number of patients on home parenteral nutrition who would potentially benefit from such a transplant. The small intestine contains a large number of passenger leucocytes commonly referred to as part of the gut associated lymphoid system (GALT) this being part of the reason for the high immunogenity of the intestinal graft. The presence and close proximity of many commensals and pathogens in the gut explains the severity of sepsis episodes once graft mucosal integrity is compromised (for example by rejection). To advance the field of intestinal- and multiorgan transplantation more data generated from reliable and feasible animal models is needed. The model provided herein combines both reliability and feasibility once established in a standardized manner and can provide valuable insight in the underlying complex molecular, cellular and functional mechanisms that are triggered by intestinal transplantation. We have successfully used and refined the described procedure over more than 5 years in our laboratory ^8-11. The JoVE video-based format is especially useful to demonstrate the complex procedure and avoid initial pitfalls for groups planning to establish an orthotopic rodent model investigating intestinal transplantation.     

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

Herein, we describe a novel technique for heterotopic abdominal heart-lung transplantation (HAHLT) in rats. The configuration of the transplant graft involves anastomosis of donor inferior vena cava (IVC) to recipient IVC, and donor ascending aorta (Ao) to recipient abdominal Ao. The right upper and middle lung lobes are preserved and function as conduits for blood flow from right heart to left heart.There are several advantages to using this technique, and it lends itself to a broad range of applications. Because the graft is transplanted in a configuration that allows for dyamic volume-loading, cardiac function may be directly assessed in vivo. The use of pressure-volume conductance catheters permits characterization of load-dependent and load-independent hemodynamic parameters. The graft may be converted to a loaded configuration by applying a clamp to the recipient’s infra-hepatic IVC. We describe modified surgical techniques for both donor and recipient operations, and an ideal myocardial protection strategy. Depending on the experimental aim, this model may be adapted for use in both acute and chronic studies of graft function, immunologic status, and variable ventricular loading conditions. The conducting airways to the transplanted lung are preserved, and allow for acute lung re-ventilation. This facilitates analysis of the effects of the mixed venous and arterial blood providing coronary perfusion to the graft.A limitation of this model is its technical complexity. There is a significant learning curve for new operators, who should ideally be mentored in the technique. A surgical training background is advantageous for those wishing to apply this model. Despite its complexity, we aim to present the model in a clear and easily applicable format. Because of the physiologic similarity of this model to orthotopic transplantation, and its broad range of study applications, the effort invested in learning the technique is likely to be worthwhile.     

Poly(ADP-ribose) Polymerase Activation and Cell Injury in the Course of Rat Heart Heterotopic Transplantation

Free radicals and other reactive species generated during reperfusion of ischemic tissues may cause DNA damage and, consequently, the activation of the nuclear enzyme poly(ADP-ribose) polymerase (PARP). An excessive PARP activation may result in a depletion of intracellular NAD + and ATP, hence cell suffering and, ultimately, cell death. The present study is aimed at clarifying the role of PARP in a heart transplantation procedure and the contribution of myocyte necrosis and/or apoptosis to this process. In our experimental model, rat heart subjected to heterotopic transplantation, low temperature global ischemia (2 h) was followed by an in vivo reperfusion (30 or 60 &#117 min). Under these conditions clear signs of oxidative stress, such as lipoperoxidation and DNA strand breaks, were evident. In addition to a marked activation, accompanied by a significant NAD + and ATP depletion, PARP protein levels significantly increased after 60 &#117 min of reperfusion. Ultrastructural analysis showed nuclear clearings, intracellular oedema and plasma membrane discontinuity. Other relevant observations were the absence of typical signs of apoptosis like caspase-3 activation and PARP cleavage, random DNA fragmentation, rise in serum levels of heart damage markers. Our results suggest that during heart transplantation, the activation of PARP, causing energy depletion, results in myocardial cell injury whose dominant feature, at least in our experimental model, is necrosis rather than apoptosis.     

一种新型大鼠心脏移植模型的制作体会

目的采用腹部套管法建立大鼠心脏移植模型,并分析该方法优劣,为器官移植研究提供合适的动物模型。方法SD大鼠60只,参照Baxter的报道进行同种腹部异位心脏移植,成功制作了该模型并总结了经验。结果共实施手术30例,成功27例,成功率90%;移植心存活30 d以上。结论新型的大鼠心脏移植模型简单易行,成功率高,适合用于器官移植研究,值得推广应用。     

大鼠颈部自体静脉移植模型两种吻合方法的比较

目的比较间断吻合和连续吻合法建立静脉桥狭窄动物模型的优劣。方法SD大鼠20只,分成两组（间断吻合组和连续吻合组）,取颈外静脉与颈总动脉行端端吻合。术后4周取下静脉桥,观察桥管通畅性,分析新生内膜与中膜的厚度、面积比。结果连续组与间断组相比手术时间更短,出血更少,但桥管通畅率低,两组内膜增生程度没有显著差异。结论连续吻合用时短,出血少,对术者要求更高,较易形成吻合口狭窄。两者造模效果一样。     

硝普钠灌注对移植小肠粘膜细胞凋亡的影响

目的：探讨外源性一氧化氮（nitricoxide,NO）供体硝普钠（sodiumnitroprusside,SNP）对移植小肠粘膜细胞凋亡的影响。方法：64只220-300g雄性SD大鼠随机分成3组：A1组（n=8）,仅行剖腹关腹手术;A2组（n=12）：12对大鼠随机作为供受体行同种异体节段小肠移植,无SNP干预;A3组（n=16）：16对大鼠随机作为供受体行同种异体节段小肠移植,SNP加入灌注液进行供肠灌注。采用前述3。组动物模型再灌注5小时肠造口标本,TUNEL法检测小肠蜡块标本的细胞凋亡情况。结果：与A1组（3．86±4．74％）相比,A2（22．44±10．94％）、A3组（17．12±8．44％）小肠粘膜的细胞凋亡指数均有显著增高（P〈0．05）,A3组较A2组细胞凋亡指数显著降低（P〈0．05）。结论：小肠移植导致小肠粘膜细胞凋亡增加,外源性NO供体SNP灌注能够显著降低植入小肠的细胞凋亡,从而可能减弱粘膜屏障的损伤。     

硝普钠灌注对移植小肠粘膜细胞凋亡的影响

目的:探讨外源性一氧化氮(nitric oxide,NO)供体硝普钠(sodium nitroprusside,SNP)对移植小肠粘膜细胞凋亡的影响。方法:64只220～300g雄性SD大鼠随机分成3组:A1组(n=8),仅行剖腹关腹手术;A2组(n=12):12对大鼠随机作为供受体行同种异体节段小肠移植,无SNP干预;A3组(n=16):16对大鼠随机作为供受体行同种异体节段小肠移植,SNP加入灌注液进行供肠灌注。采用前述3组动物模型再灌注5小时肠造口标本,TUNEL法检测小肠蜡块标本的细胞凋亡情况。结果:与A1组(3.86±4.74%)相比,A2(22.44±10.94%)、A3组(17.12±8.44%)小肠粘膜的细胞凋亡指数均有显著增高(P<0.05),A3组较A2组细胞凋亡指数显著降低(P<0.05)。结论:小肠移植导致小肠粘膜细胞凋亡增加,外源性NO供体SNP灌注能够显著降低植入小肠的细胞凋亡,从而可能减弱粘膜屏障的损伤。     

骨髓间充质干细胞与施万细胞联合移植对大鼠周围神经 损伤端侧吻合的修复效果研究

目的:探究骨髓间充质干细胞(MSCs)与施万细胞(SCs)联合移植对大鼠周围神经损伤端侧吻合的修复效果。方法:选取SD雌性大鼠60只均制作成坐骨神经损伤端侧吻合模型,并将其随机分为联合移植组、MSCs组和SCs组,分别对吻合端进行骨髓间充质干细胞与SCs联合移植、MSCs移植、SCs移植。观察分析三组大鼠的神经电生理学指标和腓神经功能指数(PFI)和神经传导速度(NCV)。结果:三组大鼠的PFI和NCV均有所改善,且联合移植组的PFI和NCV均优于其他两组,并随着时间推移损伤坐骨神经功能恢复越来越好。结论:MSCs与SCs均具有促进大鼠周围神经身上修复的功能,且两种细胞联合移植效果更加明显。