Establishment of a new pig model for auxiliary partial orthotopic liver transplantation.
OBJECTIVE
To establish a new pig model for auxiliary partial orthotopic liver transplantation (APOLT).


METHODS
The liver of the donor was removed from its body. The left lobe of the liver was resected in vivo and the right lobe was used as a graft. After the left lateral lobe of the recipient was resected, end-to-side anastomoses of suprahepatic inferior vena cava and portal vein were performed between the donor and recipient livers, respectively. End-to-end anastomoses were made between hepatic artery of graft and splenic artery of the host. Outside drainage was placed in donor common bile duct.


RESULTS
Models of APOLT were established in 5 pigs with a success rate of 80%. Color ultrasound examination showed an increase of blood flow of graft on 5(th) d compared to the first day after operation. When animals were killed on the 5(th) d after operation, thrombosis of hepatic vein (HV) and portal vein (PV) were not found. Histopathological examination of liver samples revealed evidence of damage with mild steatosis and sporadic necrotic hepatocytes and focal hepatic lobules structure disorganized in graft. Infiltration of inflammatory cells was mild in portal or central vein area. Hematologic laboratory values and blood chemical findings revealed that compared with group A (before transplantation), mean arterial pressure (MAP), central venous pressure (CVP), buffer base (BB), standard bicarbonate (SB) and K(+) in group B (after portal vein was clamped) decreased (P<0.01). After reperfusion of the graft, MAP, CVP and K(+) restored gradually.


CONCLUSIONS
Significant decrease of congestion in portal vein and shortened blocking time were obtained because of the application of in vitro veno-venous bypass during complete vascular clamping. This new procedure, with such advantages as simple vessel processing, quality anastomosis, less postoperative hemorrhage and higher success rate, effectively prevents ischemia reperfusion injury of the host liver and deserves to be spread.
Peng
Cheng-Hong
CH
Transplantation Center, Ruijin Hospital, 147 Second Ruijin Road, Shanghai 200025, China. chhpeng@medmail.com.cn
Shi
Liu-Bin
LB
Zhang
Hong-Wei
HW
Peng
Shu-You
SY
Zhou
Guang-Wen
GW
Li
Hong-Wei
HW
D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D005260:Female; D006499:Hepatic Artery / Q000601:surgery; D008102:Liver Circulation; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D023421:Models, Animal; D011169:Portal Vein / Q000601:surgery; D013157:Splenic Artery / Q000601:surgery; D034421:Sus scrofa; D014682:Vena Cava, Inferior / Q000601:surgery