| Objective:To follow with the maturity of the surgical technic, the elevation of the organ preservation technic,the development of the new type of immunodepressant,the improvement of the monitoring of perioperative period, the achievement ratio of liver transplantation was elevated stedily, and the survival rate of the donator has already exceed 80% at the end of last century.However,the incidence rate of the biliary complications after liver transplantation has reached 10%～34%,which has affected the live time and the quality of life seriously of the donee after liver transplantation. This experiment is based on the model of rat autologous orthotopic liver transplantation. To investigate the effect on the intrahepatic cholangiocytes mediated by hypoxic preconditioning(HP) after liver graft and the role of vascular endothelial growth factor (VEGF),which may offer the information for clinical practice,lessen the biliary complications after liver transplantation,elevate the quality of life and the survival rate after liver transplantation.METHODS:SD rats were assigned into three groups randomly, including group A: autologous liver transplantation (n=50); group B: hypoxic preconditioning before operation (n=50),which administrated 90 minutes by the nitrogen oxygen atmosphere(8% oxygen) with 5L/min flowing rate at 24h preoperation ; group C: sham operation (n=8). Blood samples were collected at 6,12,24,48 huors after operation of group A and B for examination of the serum total bilirubin (TBIL),direct bilirubin (DBIL)and alkaline phosphatase (ALP);Immunohistochemical method was used to detect the expression of VEGF and proliferation rate of cholangiocytes; The micro-structure of biliary epithelial cell and the ultramicro-structure of cholangiole were determined in three groups.RESULTS:(1) The successful standard of the operation: the rat analepsia and free itself instantly,and was able to maintain effective respiration and heartbeat. Group A and Group B each had 50 effective cases , anhepatic phase was controlled in 20±2.2 minutes.(2) The status of the serum TBIL,DBIL,ALP: As compared with group C,the TBIL,DBIL,ALP was increased at whole process in group A and B(p<0.05), but compared with group B ,the data increased more obviously at whole process in group A(p<0.05),which achieved the peak value at 24h after operation.(3) The staus of the expression of VEGF and proliferation cell nuclear antigen index(PI) of cholangiocytes: VEGF can be detected in all groups on the cholangiocytes, to compared with group C the expression was more obviously at whole process in group Aand B(p<0.05),but compared with group A, the expression of VEGF was more obviously at whole process in group B(p<0.05), which achieved the peak value at 12h after operation; As compared with group C, the proliferation rate of cholangiocytes was higher in group A and B(P<0.05),the PI was the highest in group B(P<0.05).(4) The micro-structure of the biliary epithelial cell:the biliary epithelial cell appeared column and lined up in order , the cell nucleus located at the basilar part, there was no inflammatory cell infiltration, there was no or less necrotic and amotic epithelial cell in the lumens in group C.6h after operation,the biliary epithelial cell lined disord,appeared diversify morphous and inflammatory cell infiltration in group A, the cellular damage achieved the most seriously and the amotic cells were clear in the lumens at 24h after operation.(5) The ultramicro-structure of cholangiole: the cholangiole was distened, microvilli were swelled,decresed or obsolescent and the degree of cholestasis through electron microscope were all more obviously in group A.CONCLUTION:The HP has protective effect on cholangiocytes after liver graft ,and its mechanism may relate with the over expression of VEGF on cholangiocytes induced by HP.
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