| OBJECTIVE: (1) To investigate simultaneous liver-kidney transplantation(SLKT),a new model of simultaneous liver-kidney transplantation was established;(2)To study the correlation between rejection and apoptosis of simultaneous liver-kidney transplantation in the rats and to research the immunoppressive effects of rapamycin on rejection and apoptosis.METHODS: The liver and kidney of donor were ablated simultaneously.The graft portal vein (PV) and inferorenal inferior ven cava(IVC) were anastomosised by the means of double cuff methods.The supraliver IVC were anastomosised end to side to the recipient supraliver IVC.The graft urethrea and bile duct was anastomosised by simple inside bracket, pseuooperated SD(SD -SD)rats were used as control group by simultaneous liver-kidney reansplantation(group I ). By using a model of liver-kidney allotransplanted rats(SD-Wistar),based on different treatment, the rats were divided into rejection group(group II ),Rapamycin (2mg kg-1 d-1) -treated group(group III ), rapamycin (4mg kg-1 d-1)-treated group(group IV). Extract blood to examination serum ALT and Cr in all rats; Five rats were killed on the day 1,3,5,7 in each group postoperatively. The graft were harvested for the examination of pathology and assay of apoptosisRESULTS: The time of operation: The donor operation time was 38+5min, recipient no-liver time 18+3min; recipient operation 81 + 13min, thesuccessful rate was 80. 0%, 70. 0%, 80. 0%, 80. 0% respectively, serum Cr and ALT were both enhanced postoperatively except group 1 (P<0.05) There was a significant difference in the group II with other groups (P<0.01). The pathological evidences of rejection were not detected in all rats on the day 1, 3 after operation. There episodes of I and II rejection in group II on the day 5 and 7 after operation respectively. On the day 7 after operation, the mild rejection occurred hi the group ffl and no rejected trail existed in the group IV. The quantity of apoptosis was increased in the early stage and episode of graft rejection. There was a significant difference in the quantity of apoptosis among the different stages of rejection(P<0.01). Rapamycin did not cut down the course of rejection. CONCLUTION: ( 1 ) This model of simultaneous liver-kidney trnasplantation in rats is simple and feasible; (2) A large number of apoptotic hepatocyte and tubular epithelial cells would apparent during the course of rejection. It could be another reliable indicator for pathologic findings of rejection and have a positive correlation with progressive acute rejection. (3) The immunoppression of rapamycin depends on the dose and can t restrain the apoptosis of the hepatocyte and tubular epithelial cells completely. |
