[Hemodynamic tolerance and rapid hypertrophy of a hepatic graft corresponding to less than 30% of the ideal mass in pigs].
OBJECTIVE
Evaluation of a new pig liver transplantation technique for survival and hypertrophy of a small-sized graft by providing adapted and controlled venous portal flow.


METHODS
[corrected] Twenty Large-White pigs underwent heterotopic liver transplantation after a mesocaval shunt and ligation of the superior mesenteric vein downstream from the shunt. The donor-to-recipient weight ratio was below 30%. Furthermore, recipient's biliary duct and portal vein into the hilum were tied. In a control group, no mesocaval shunt was performed and the graft received the entire splanchnic venous flow.


RESULTS
The mesocaval shunt provided diversion of 60% of the splanchnic blood flow. The median survival of study pigs was 39 days (range: 8-98). Median serum bilirubin levels at 1 week were 12 micromol/L (range: 4-59). At autopsy, graft weight was increased to 2.7 times the initial weight and histological findings were normal. In the control group, all pigs died quickly from acute splanchnic congestion.


CONCLUSIONS
In a model of heterotopic liver transplantation using small-sized grafts, complete diversion of mesenteric blood flow through a mesocaval shunt resulted in hemodynamic tolerance and hypertrophy of a graft corresponding to less than 30% of the ideal mass.
Pouyet
M
M
Faculté Laennec, Lyon, France.
Paquet
C
C
Mechet
I
I
Le Derf
Y
Y
Bernard
P
P
Figueiredo
P
P
Berger
F
F
Boillot
O
O
D000714:Anastomosis, Surgical; D000818:Animals; D001652:Bile Ducts; D001663:Bilirubin / Q000097:blood; D003250:Constriction; D006439:Hemodynamics; D006984:Hypertrophy; D008026:Ligation; D008099:Liver / Q000473:pathology*; D016031:Liver Transplantation / Q000379:methods*; D008642:Mesenteric Veins / Q000601:surgery; D023421:Models, Animal; D009929:Organ Size; D011169:Portal Vein / Q000601:surgery; D013152:Splanchnic Circulation; D013552:Swine; D016042:Transplantation, Heterotopic
D001663:Bilirubin