220次大鼠心脏移植的经验体会

作者采用Ono等创建的大鼠异位心脏移植模型,并作了部分改进,手术成功率达93.5％,手术时间和供心缺血时间缩短。本文着重介绍手术方法与经验体会。     

小鼠异位肢体复合组织移植模型的建立

目的建立稳定的小鼠异位肢体复合组织移植模型。方法选用25对C57BL/6小鼠行同品系异位肢体复合组织移植手术。取供体小鼠后肢,于腹股沟韧带下缘起沿股动脉、股静脉向上游离,电凝切断除股静脉、股动脉外所有分枝血管至髂外动脉、髂外静脉,断髂外动脉、髂外静脉后,横断股骨、股部肌肉。将供体髂外动脉、髂外静脉分别与受体小鼠右侧颈总动脉、颈外静脉行端侧吻合。连续缝合供体皮缘于受体皮肤切缘固定肢体。于供肢胫骨远端关节处切断,结扎残端。结果手术成功率76%,总手术时间(87.1±10.1)min,供体获取时间(23.8±4.9)min,血管吻合时间(55.3±9.6)min。结论小鼠异位肢体复合组织移植成功率较高,稳定可靠,是一种新的研究移植免疫的理想的动物模型。     

大鼠局灶性脑缺血模型的有效制备

目的比较三种不同手术方法制作大鼠永久性脑缺血模型的效果,包括死亡率、神经功能评分、脑梗死体积、手术效率。方法将采用不同手术方法制备脑缺血模型的大鼠随机分为三组。1组在术中分别结扎颈总动脉（CCA）、颈外动脉（ECA）、枕动脉、翼腭动脉,并且用动脉夹对颈内动脉（ICA）进行临时夹闭;2组在术中分别结扎颈总动脉、颈外动脉,暴露枕动脉和翼腭动脉但不结扎,用丝线悬挂颈内动脉而不是用动脉夹夹闭,线栓在显微镜直视下插入颈内动脉越过翼腭动脉起始点至大脑中动脉分叉处;3组只暴露颈总动脉、颈外动脉和颈内动脉,结扎颈总动脉、颈外动脉,丝线悬挂颈内动脉,显微镜下将线栓盲插至颈内动脉大脑中动脉分叉处。分别检测三组模型的死亡率、神经功能评分、梗死体积、手术时间。结果第3组制作动物模型的方法所花费时间平均为17.5 min,死亡率较低,神经功能评分及梗死体积稳定。结论采用第3组手术方法可以缩短手术时间,提高手术效率,能够高效地制作出更加稳定的可用于临床实验的大鼠脑缺血模型。     

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.     

大鼠异位工作型心脏移植模型的建立

目的 建立大鼠腹腔异位工作型心脏移植动物模型.方法 Wistar大鼠30只,将供心主肺动脉与左房吻合,再将供心移植到受体腹部,将升主动脉与供心腹主动脉端侧吻合,使得左心房获得前负荷,成为工作型心脏.结果 成功建立大鼠腹腔异位工作型心脏移植模型,15例成功11例,手术成功率为73%.手术平均时间为(38.8±5.7)min.移植心脏获得长期存活,在28 d后通过超声观察可见供体心脏工作正常.结论 手术的关键是提高供心的摘取技术及受体的血管吻合技术,同时术后给与供心适当的按摩辅助也非常必要.此模型可以更好的用于移植免疫学的研究.     

小鼠左肺原位移植模型的建立

目的通过显微外科技术建立小鼠原位肺移植模型,为肺移植研究提供动物模型。方法采用C57BL/6小鼠作为供、受体,行同基因小鼠原位左肺移植,使用Cuff套管法进行气管及血管吻合。术后7、14、21、28 d取移植肺及原肺,行HE染色,评价肺移植后效果。结果学习曲线后,共30例小鼠移植,手术成功率89%,小鼠成活率100%。供体手术时间:(35.2±9.81)min,受体手术时间:(24.6±7.42)min,冷缺血时间是:(46.6±8.92)min,热缺血时间是:(17.2±3.08)min。同基因移植物大体及病理无明显改变,病理显示与原肺无差别。结论本技术能够方便快捷建立小鼠肺移植模型,成功率高,可重复性强,符合原位肺移植临床生理,是研究肺移植发病机制和治疗的良好动物模型。     

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。     

乌贼墨黑色素对小鼠脏器系数的影响及排铅效果的研究北大核心CSCD

本文研究了乌贼墨黑色素对小鼠脏器系数的影响以及对铅中毒小鼠的排铅效果,采用腹腔注射醋酸铅溶液建立铅中毒小鼠实验模型,对铅中毒小鼠进行乌贼墨黑色素灌胃治疗,24 h后取眼球血,断颈处死并取肝脏及脑组织,用电感耦合等电子体发射光谱(ICP-AES)测定小鼠血液、肝脏以及脑组织中的铅含量。结果表明,乌贼墨黑色素对小鼠肝脏和脑的脏器系数无显著影响;小鼠染铅30 min后,用乌贼墨黑色素灌胃1次进行治疗,治疗组小鼠的肝、血液中的铅含量与铅模型组相比差异极显著(P<0.01),脑铅下降不明显。小鼠染铅24 h后,用乌贼墨黑色素灌胃1次进行治疗,治疗组小鼠的肝、血液中的铅含量与铅模型组相比差异极显著(P<0.01),脑铅下降差异显著(P<0.05)。乌贼墨黑色素对24 h内铅中毒小鼠有显著的排铅效果。     

乌贼墨黑色素对小鼠脏器系数的影响及排铅效果的研究

本文研究了乌贼墨黑色素对小鼠脏器系数的影响以及对铅中毒小鼠的排铅效果,采用腹腔注射醋酸铅溶液建立铅中毒小鼠实验模型,对铅中毒小鼠进行乌贼墨黑色素灌胃治疗,24 h后取眼球血,断颈处死并取肝脏及脑组织,用电感耦合等电子体发射光谱(ICP-AES)测定小鼠血液、肝脏以及脑组织中的铅含量。结果表明,乌贼墨黑色素对小鼠肝脏和脑的脏器系数无显著影响;小鼠染铅30 min后,用乌贼墨黑色素灌胃1次进行治疗,治疗组小鼠的肝、血液中的铅含量与铅模型组相比差异极显著(P0.01),脑铅下降不明显。小鼠染铅24 h后,用乌贼墨黑色素灌胃1次进行治疗,治疗组小鼠的肝、血液中的铅含量与铅模型组相比差异极显著(P0.01),脑铅下降差异显著(P0.05)。乌贼墨黑色素对24 h内铅中毒小鼠有显著的排铅效果。     

大鼠腹腔内工作型心脏移植模型的改进

目的构建大鼠腹腔内工作型心脏移植模型,总结影响模型成功率的因素。方法 Brown Norway到Lewis大鼠心脏移植90例,其中预实验50例,正式实验40例。采用肺动脉和左房吻合、主动脉和受体腹主动脉吻合的方法建立工作型心脏移植,统计手术存活率和死亡原因,分析确保成功率的关键因素。结果术者通过练习,手术成功率稳定77.5%,供心冷缺血时间为(34±5)min,整个手术时间为(71±11)min。HE染色显示移植后发生了免疫反应,移植模型可靠。结论决定手术成功率的影响因素众多,其中主要因素有:合格的实验动物、供体心脏的保护、快速有效的血管缝合和术后动物护理。     

Heterotopic heart transplantation in mice

The mouse heterotopic heart transplantation has been used widely since it was introduced by Drs. Corry and Russell in 1973. It is particularly valuable for studying rejection and immune response now that newer transgenic and gene knockout mice are available, and a large number of immunologic reagents have been developed. The heart transplant model is less stringent than the skin transplant models, although technically more challenging. We have developed a modified technique and have completed over 1000 successful cases of heterotopic heart transplantation in mice. When making anastomosis of the ascending aorta and abdominal aorta, two stay sutures are placed at the proximal and distal apexes of recipient abdominal aorta with the donor s ascending aorta, then using 11-0 suture for anastomosis on both side of aorta with continuing sutures. The stay sutures make the anastomosis easier and 11-0 is an ideal suture size to avoid bleeding and thrombosis.When making anastomosis of pulmonary artery and inferior vena cava, two stay sutures are made at the proximal apex and distal apex of the recipient s inferior vena cava with the donor s pulmonary artery. The left wall of the inferior vena cava and donor s pulmonary artery is closed with continuing sutures in the inside of the inferior vena cava after, one knot with the proximal apex stay suture the right wall of the inferior vena cava and the donor s pulmonary artery are closed with continuing sutures outside the inferior vena cave with 10-0 sutures. This method is easier to perform because anastomosis is made just on the one side of the inferior vena cava and 10-0 sutures is the right size to avoid bleeding and thrombosis. In this article, we provide details of the technique to supplement the video.     

大鼠原位肝移植急性排斥反应模型的建立

目的建立大鼠原位肝移植急性排斥反应模型。方法采用改进的Limmer和Kamada的二袖套法建立大鼠肝移植模型。将大鼠分为2组：①实验组：急性排斥反应组（Wistar→SD）;②对照组：免疫耐受组（SD→SD）。结果免疫排斥组肝存活时间（7.4±1.7）d低于对照组（18.9±7.6）d,差异有统计学意义0.05（P〈0.05）。结论Wistar→SD大鼠之间的原位肝移植模型可产生中、重度的免疫排斥反应,是一种较理想的可作为研究急性排斥反应的动物模型。     

A Modified Method for Heterotopic Mouse Heart Transplantion

Mice are often used as heart transplant donors and recipients in studies of transplant immunology due to the wide range of transgenic mice and reagents available. A difficulty is presented due to the small size of the animal and the considerable technical challenges of the microsurgery involved in heart transplantation. In particular, a high rate of technical failure early after transplantation may result from recipient death and post-operative complications such as hind limb paralysis or a non-beating heart. Here, the complete technique for heterotopic mouse heart transplantation is demonstrated, involving harvesting the donor heart and its subsequent implantation into a recipient mouse. The donor heart is harvested immediately following in situ perfusion with cold heparinized saline and transection of the ascending aorta and pulmonary artery. The recipient operation involves preparation of the abdominal aorta and inferior vena cava (IVC), followed by end-to-side anastomosis of the donor aorta with the recipient aorta using a single running 10-0 microsuture and a similar anastomosis of the donor pulmonary artery with the recipient IVC. Following the operation the animal is injected with 0.6 ml normal saline subcutaneously and allowed to recover on a 37 °C heating pad. The results from 227 mouse heart transplants are summarized with a success rate at 48 hr of 86.8%. Of the 13.2% failures within 48 hr, 5 (2.2%) experienced hind limb paralysis, 10 (4.4%) had a non-beating heart due to graft ischemic injury and/or thrombosis, while 15 (6.6%) died within 48 hr.     

Fertility and germline transmission of donor haplotype following germ cell transplantation in immunocompetent goats

Transplantation of spermatogonial stem cells into syngeneic or immunosuppressed recipient mice or rats can result in donor-derived spermatogenesis and fertility. Recently, this approach has been employed to introduce a transgene into the male germline. Germ-cell transplantation in species other than laboratory rodents, if successful, holds great promise as an alternative to the inefficient methods currently available to generate transgenic farm animals that can produce therapeutic proteins in their milk or provide organs for transplantation to humans. To explore whether germ-cell transplantation could result in donor-derived spermatogenesis and fertility in immunocompetent recipient goats, testis cells were transplanted from transgenic donor goats carrying a human alpha-1 antitrypsin expression construct to the testes of sexually immature wild-type recipient goats. After puberty, sperm carrying the donor-derived transgene were detected in the ejaculates of two out of five recipients. Mating of one recipient resulted in 15 offspring, one of which was transgenic for the donor-derived transgene. This is the first report of donor cell-derived sperm production and transmission of the donor haplotype to the next generation after germ-cell transplantation in a nonrodent species. Furthermore, these results indicate that successful germ-cell transplantation is feasible between immunocompetent, unrelated animals. In the future, transplantation of genetically modified germ cells may provide a more efficient alternative for production of transgenic domestic animals.     

Orthotopic Aortic Transplantation in Mice for the Study of Vascular Disease

Vascular procedures involving anastomoses in the mouse are generally thought to be difficult and highly dependent on the skill of the individual surgeon. This is largely true, but there are a number of important principles that can reduce the difficulty of these procedures and enhance reproducibility. Orthotopic aortic transplantation is an excellent procedure in which to learn these principles because it involves only two end-to-end anastomoses, but requires good suturing technique and handling of the vessels for consistent success. This procedure begins with the procurement of a length of abdominal aorta from a donor animal, followed by division of the native aorta in the recipient. The procured aorta is then placed between the divided ends of the recipient aorta and sutured into place using end-to-end anastomoses. To accomplish this objective successfully requires a high degree of concentration, good tools, a steady hand, and an appreciation of how easily the vasculature of a mouse can be damaged, resulting in thrombosis. Learning these important principles is what occupies most of the beginner''s time when learning microsurgery in small rodents. Throughout this protocol, we refer to these important points. This model can be used to study vascular disease in a variety of different experimental systems^1-8. In the context shown here, it is most often used for the study of post-transplant vascular disease, a common long-term complication of solid organ transplantation in which intimal hyperplasia occurs within the allograft. The primary advantage of the model is that it facilitates quantitative morphometric analyses and the transplanted vessel lies contiguous to the endogenous vessel, which can serve as an additional control⁹. The technique shown here is most often used for mice weighing 18-25 grams. We have accumulated most of our experience using the C57BL/6J, BALB/cJ, and C3H/HeJ strains.     

The Mesenchymal Stem Cells Derived from Transgenic Mice Carrying Human Coagulation Factor VIII Can Correct Phenotype in Hemophilia A Mice

Hemophilia A （HA） is an inherited X-linked recessive bleeding disorder caused by coagulant factor VIII （FVIII） deficiency. Previous studies showed that introduction of mesenchymal stem cells （MSCs） modified by FVIll-expressing retrovims may result in phenotypic correction of HA animals. This study aimed at the investigation of an alternative gene therapy strategy that may lead to sustained FVIII transgene expression in HA mice. B-domain-de/eted human FVIll （hFVHIBD） vector was microinjected into single-cell embryos of wild-type mice to generate a transgenic mouse line, from which hFVIIIBD-MSCs were isolated, followed by transplantation into HA mice. RT-PCR and real-time PCR analysis demonstrated the expression of hFVlllBD in multi-organs of recipient HA mice. Immunohistochemistry showed the presence of hFVIIIBD positive staining in multi-organs of recipient HA mice. ELISA indicated that plasma hFVIIIBD level in recipient mice reached its peak （77 ng/ mL） at the 3rd week after implantation, and achieved sustained expression during the 5-week observation period. Plasma FVIII activities of recipient HA mice increased from 0% to 32% after hFVIIIBD-MSCs transplantation. APTT （activated partial thromboplastin time） value decreased in hFVIIIBD-MSCs transplanted HA mice compared with untreated HA mice （45.5 s vs. 91.3 s）. Our study demonstrated an effective phenotypic correction in HA mice using genetically modified MSCs from hFVIIIBD transgenic mice.     

硬膜外导管在大鼠肾移植血管吻合中的应用

目的建立一种手术难度低,成功率高的大鼠肾移植模型。方法 Wistar大鼠作供体,SD大鼠作受体,将供体腔静脉与受体肾静脉端端吻合,供体腹主动脉与受体腹主动脉端侧吻合,供体膀胱瓣与受体膀胱吻合。根据血管吻合时应用硬膜外导管与否,将受体分为有支架组和无支架组两组。结果有支架组共进行肾移植30次,成活26只;无支架组共进行肾移植20次,成活10只。有支架组的成活率86.7%（26/30）较无支架组50.0%（10/20）明显提高（P〈0.05）,血管吻合总时间（22±2）min较无支架组（32±2）min明显缩短（P〈0.05）。结论硬膜外导管应用于大鼠肾移植血管吻合,降低了手术难度,减少了吻合口出血,提高了手术成功率。     

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.     

Surgical technique in the rat model of kidney transplantation

Today successful kidney transplantation procedures, techniques and immunosuppression protocols are a consequence of extensive research on animal models. During every transplantation surgery there are two crucial points for the success of the entire procedure: vascular (arterial end venous) and ureteral or ureterovesical anastomosis. Renal artery and vein of the donor kidney can be anastomosed end-to-side to the abdominal aorta and vena cava of the recipient (heterotopic transplantation), or end-to-end to the remains of renal artery and vain of the recipient (orthotopic transplantation) after nephrectomy. The ureter can be anastomosed also end-to-end or we can connect it directly to the urinary bladder (ureterocystoneostomy). The aim of this study was to elucidate which technique has better results according to: animal survival, reperfusion and perfusion of the transplanted kidney, elimination of the urine from the transplanted kidney and procedure costs. The study included 240 (120 donors and 120 recipients) male Wistar rats (3 months old; weight 250-300 g Our results are clearly showing that the end-to-end vascular anastomosis, and Paquins ureterovesical anastomosis have better results in transplanted rat kidneys survival and urine drainage compared to end-to-side vascular anastomosis and end-to-end ureteral anastomosis. Based on our experience we can conclude that described methods of end-to-end vascular anastomosis and Paquins ureterovesical anastomosis are less technically demanding and have a shorter learning curve. Therefore, we can recommend the use of described methods in kidney transplantation related researches.     

Expansion of murine spermatogonial stem cells through serial transplantation

Mammalian male germ cells might be generally thought to have infinite proliferative potential based on their life-long production of huge numbers of sperm. However, there has been little substantial evidence that supports this assumption. In the present study, we performed serial transplantation of spermatogonial stem cells to investigate if they expand by self-renewing division following transplantation. The transgenic mouse carrying the Green fluorescent protein gene was used as the donor cell source that facilitated identification and recollection of colonized donor germ cells in the recipient testes. The established colonies of germ cells in the recipient testes were collected and transplanted to new recipients. This serial transplantation of spermatogonial stem cells repopulated the recipient testes, which were successfully performed sequentially up to four times from one recipient to the next. The incubation periods between two sequential transplantations ranged from 55 to 373 days. During these passages, the spermatogonial stem cells showed constant activity to form spermatogenic colonies in the recipient testis. They continued to increase in number for more than a year following transplantation. Colonization efficiency of spermatogonial stem cells was determined to be 4.25% by using Sl/Sl(d) mice as recipients that propagated only undifferentiated type A spermatogonia in their testes. Based on the colonization efficiency, one colony-forming activity was assessed to equate to about 20 spermatogonial stem cells. The spermatogonial stem cells were estimated to expand over 50-fold in 100 days in this experiment.