title: A new technique for total hepatectomy in the pig for testing liver support devices.
abstract: BACKGROUND
  A large animal model of total hepatectomy is suitable to test the efficacy of any system designed to support patients in hepatic coma. The models previously described in the pig entail a significant degree of surgical trauma, which might alter the evolution of the ensuring hepatic failure and compromise the reproducibility of the model.
  
  
  METHODS
  Twenty-eight pigs underwent a total hepatectomy according to a new technique. A model was considered satisfactory when it required no blood transfusions and when hematologic and hemodynamic parameters determined before, during, and until 4 hours after hepatectomy showed no significant variations. Moreover, to revive the pattern of hepatic coma produced in the anhepatic model, 7 pigs were monitored until brain death occurred.
  
  
  RESULTS
  Twenty-five pigs (89%) underwent a smooth total hepatectomy with minimal variations of the selected parameters. They constituted a highly homogeneous group. Survival of the 7 pigs, followed up until brain death occurred, ranged from 625 to 1595 minutes (mean 1013.57 minutes). The animals remained stable until a few hours before brain death, an event heralded by a final sharp increase of the serum ammonia level and by a well-evident decline of both arterial pressure and liver-dependent clotting factors.
  
  
  CONCLUSIONS
  This technique of total hepatectomy allows the construction of a reproducible model of anhepaty suitable to test the efficacy of any system conceived to temporarily replace hepatic functions.
authors.affiliation: Department of Oncology, University of Pisa, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Filipponi
authors.forename: U
authors.initials: U
authors.lastname: Boggi
authors.forename: L
authors.initials: L
authors.lastname: Meacci
authors.forename: S
authors.initials: S
authors.lastname: Burchielli
authors.forename: F
authors.initials: F
authors.lastname: Vistoli
authors.forename: R
authors.initials: R
authors.lastname: Bellini
authors.forename: C
authors.initials: C
authors.lastname: Prota
authors.forename: L
authors.initials: L
authors.lastname: Colizzi
authors.forename: C
authors.initials: C
authors.lastname: Kusmic
authors.forename: D
authors.initials: D
authors.lastname: Campani
authors.forename: C
authors.initials: C
authors.lastname: Gneri
authors.forename: M G
authors.initials: MG
authors.lastname: Trivella
authors.forename: F
authors.initials: F
authors.lastname: Mosca
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D001926:Brain Death; D004195:Disease Models, Animal; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006501:Hepatic Encephalopathy / Q000601:surgery / Q000628:therapy; D007601:Jugular Veins / Q000601:surgery; D008099:Liver / Q000098:blood supply / Q000601:surgery; D017093:Liver Failure / Q000601:surgery* / Q000628:therapy*; D019164:Liver, Artificial; D011169:Portal Vein / Q000601:surgery; D013552:Swine; D014682:Vena Cava, Inferior / Q000601:surgery