The Pathological Physiological Changes And The Expression Of HIF-1α After Bile Duct Ischemia-reperfusion Injury

Background: At present, the liver transplantation in the treatment of end-stage liverdisease has become the most effective choice, but the biliary tract complications after livertransplantation, is often lead to graft loss and to be one of the leading causes of second livertransplantation. Bile duct ischemia reperfusion injury is the main cause of bile duct injuryafter living donor liver transplantation, including biliary most easily affected by heat ischemiainjury, and how to ensure the safety of the bile duct resistance heat ischemia time limit is livertransplantation clinically to solve problem, but the intrahepatic bile ducts at room temperaturethat can tolerate heat ischemia has no determined how long.Methods: The SD rats were randomly divided into control group, according to thelottery method combined blocking hepatic artery, common bile duct and portal vein15,30,45,60min group, common bile duct, liver artery and portal vein, bile duct, the hepatic artery,portal vein joint block15,30,45,60min group flat top left and right hepatic duct openingapplication without damage clip joint GaBi bravery manager, hepatic artery, portal vein andits loose connective tissue, blocking15,30,45,60min after removing no injuried arteries clip,restoration of bile duct and liver blood flow. Groups, respectively, prior to reflow reflow12h,1,2,3,7d in SD rat inferior vena venous blood, separation of serum liver functiondetermined (TBIL, AST,ALT,GGT,ALP), light microscope to observe the liver tissuepathological changes, under the electron microscope to observe the changes of theultrastructure of intrahepatic bile duct epithelial cells, using immunohistochemical SABCmethod to detect HIF-1α in ischemia-reperfusion12h,1d and2d,3d,7d expression.Results: The experimental group after each phase TBIL, AST, ALT, ALP, GGTsignificantly increased when compared with the corresponding phase control (P <0.05), withthe extension of biliary ischemia time, ischemia within30min, liver tissue pathology changerelatively light, give priority to with inflammatory cells infiltration and cell edema, focalnecrosis is dot or small flake, and hot ischemia after30min, bile duct epithelial cells necrosisfalls off, in the multiple focal liver tissue necrosis foci, large flake, irreversible damage; Asthe warm ischemia time prolonged,the corresponding phase HIF-1α expression enhancement.Conclusion: The experimental research show that SD rats can be well resistance heatischemia within30min.