磁吻合肝脏快速植入对肝移植围手术期肠道免疫微生态的影响

项目名称： 磁吻合肝脏快速植入对肝移植围手术期肠道免疫微生态的影响

项目编号： No.81470896

项目类型： 面上项目

立项/批准年度： 2015

项目学科： 医药、卫生

项目作者： 吕毅

作者单位： 西安交通大学

项目金额： 84万元

中文摘要： 肝硬化患者常因伴随门静脉高压使得肠道粘膜屏障受损及肠道免疫微生态失衡，而行肝移植治疗时无肝期的存在势必将进一步加剧肠粘膜屏障损伤和肠免疫微生态失衡,从而导致围术期细菌移位及感染的发生。但目前无肝期时间对肠免疫微生态的影响及二者的量效关系尚不明确。我们经过近10年的努力，研制出了一系列磁吻合器械，可进行肝脏附属管道的无缝线快速重建，实现超短无肝期的肝移植术。基于此，我们提出：利用该技术可通过供肝快速植入实现肝移植术中的损伤控制，有望减轻无肝期造成的肠粘膜屏障损伤，达到改善围术期肠道微生态和全身免疫炎症平衡的目的。为此，本课题拟利用肝硬化大鼠模型，通过检测肠粘膜机械屏障和免疫屏障损伤、肠菌群结构变化、细菌移位等研究肝硬化状态下门脉阻断时间与围术期肠粘膜屏障损伤及肠道免疫微生态失衡之间的量效关系；进一步通过磁吻合快速肝脏植入，研究超短无肝期肝移植改善肠道免疫微生态和全身免疫炎症状态的作用。

中文关键词： 肝移植；肠粘膜屏障；肠道菌群；肝硬化；磁吻合术

英文摘要： Patients with liver cirrhosis often appear intestinal mucosal barrier damage and intestinal dysbiosis, due to accompanied portal hypertension. It could be aggravated significantly by blocking of the portal vein during liver transplantation, which result in perioperative bacterial translocation and infection. But so far, the effects of the anhepatic phase on the intestinal microflora and immune and their quantitative relationship is unclear. Our group has developed a series of magnetic technologies during past ten years' research work, which could let us implant the donor liver in the acceptor' body rapidly and perform liver transplantation with extremely short anhepatic phase. Based on these finding, we proposed that this technology can achieve damage control by implanting the donor liver in acceptor' body rapidly, and thereby alleviate the damage of intestinal mucosa caused the anhepatic phase during liver transplantation, which could improve the perioperative intestinal microecological and systemic immune and inflammation. Therefore, this study will generate a rat model of liver cirrhosis, and explore the impact of the portal vein blocking time on the intestinal immune system and microbial ecosystem during the perioperation, by examining the the changes of intestinal barrier, intestinal immune system and intestinal flora. What' more, we will further study the influence of extremely short anhepatic phase on the intestinal immune system, microbial ecosystem and systemic immune and inflammation by implanting the donor liver into acceptor' body rapidly.

英文关键词： Liver transplantation;Intestinal mucosal barrier;Intestinal flora;Cirrhosis;Magnamosis