| Objective: Our country is one of countries with the higher morbidity of liver ailment and most large number of death of liver function failure in the world. Liver transplantation is developing quickly and number of patients performed liver transplantation is increasing in our country. Liver dysfunction or failure is still a significant clinical problem after liver transplantation. Despite the significant improvement of clinical outcome of liver transplantation during the last decade, the dramatic organ shortage for liver transplantation forces consideration of cadaveric or steatotic grafts. These grafts have a higher susceptibility to ischemia-reperfusion injury, resulting in severe postoperative complications with significant impact on morbidity and mortality. Moreover, it directly has an influence on the outcome of clinic liver transplantation. To research on the role of heme oxygnase 1(HO-1) during ischemia-reperfusion injury in rat liver transplantation model, we successfully establish a stable rat liver transplantation model with modified "Kamada's two cuff" technique. The model is the basis of following research. Methods: The models of the SD rat were established with modified Kamada's two cuff technique. We monitored the survival rate and complications of operated rat. Results: About four hundred cases of rat orthotopic liver transplantation operations were performed in total. The operation time of donor was (21.3±6)min, cuff preparation time of the whole graft group was (14.6±3)min, cuff preparation time of the 60% graft group was (18.6±3)min, the operation time of recipient was (43.6±6)min, the anhepatic phase was (19.6±2.5)min. The whole graft group of the survival rate of one week is up to 90.7%. The 60% graft group of the survival rate of one week is up to 83.9%. We successfully establish a stable rat liver transplantation model. Conclusions: If you want to establish a stable rat liver transplantation model, you must master enough microsurgery skills and an intimate knowledge of abdomen anatomy of rat. Moreover, you have to repeat training in OLT for a phase. The sophisticated microsurgical technique and the delicate surgical manipulation is the key to successfully perform a rat orthotopic liver transplantation. Obective: Advances in immunosuppression protocols and surgical procedures have considerably improved patient survival after liver transplantation. But nowadays there is still a dramatic organ shortage for liver transplantation. An important factor that has become of great concern to transplant centers is the widening gap between the donor supply and the number of patients awaiting OLT. As it forces consideration of some marginal donors, such as older,cadaveric or steatotic grafts, and new surgical techniques, such as splitting liver transplantation, living donor liver transplantation to solve this problem. Small-for-size grafts are usually used in these new surgical techniques. However, both margical grafts and small-for-size grafts have a higher susceptibility to ischemia reperfusion injury (IRI), resulting in severe postoperative complications with significant impact on morbidity and mortality. Moreover, it directly has an influence on the outcome of clinic liver transplantation.Oxidant stress reaction is one of most important causes of IRI during ischemia/reperfusion. Heme oxygenase-1(HO-1) plays an important role on preventing tissues and organs from oxidant stress injury, which remains currently one of the most active areas of investigation. In order to clarify the role of heme oxygenase-1 during IRI after liver transplantation, we enhanced HO-1 expression of donors by gene transfection before transplantation and then study the effects and mechanisms of HO-1 during IRI after rat liver transplantation. We can try to find a novel method and strategy to prevent IRI and make better use of marginal liver and expand organ donor pool. Methods: We generated recombinant adenoviral vector encoding HO-1 gene (Ad5-HO-1) by molecular biology method, which was administered to donors 48 ho... |
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