title: Clamping the supra-celiac aorta can effectively increase the success rate of orthotopic rat liver transplantation by increasing the tolerable time of the anhepatic phase.
abstract: BACKGROUND
  Although using a Kamada model with a cuff approach for vascular anastomosis shortens the anhepatic time in orthotopic rat liver transplantation (ORLT), cardiac arrest is still often encountered during the anhepatic phase. We hypothesize that low cardiac output is the reason for this. In this study, we used the supra-celiac aorta clamp (SCAC) method during the anhepatic phase in ORLT to evaluate the success rate.
  
  
  METHODS
  Spraque-Dawley rats were used in this the study. First, we tested the time between the clamping of the supra-hepatic inferior vena cava (IVC) clamped and cardiac arrest in between two groups according to whether SCAC was performed (n = 40) or not (n = 20). Clamping of the supra-hepatic IVC was performed 30 s or 1 min after SCAC (n = 20 for each) in the SCAC group. Second, we performed the Kamada method for ORLT in two groups according to whether SCAC was performed (n = 20, 1-min SCAC) or not (n = 20). Successful ORLT was defined as a recipient rat surviving more then 5 days.
  
  
  RESULTS
  The mean time between IVC clamping and cardiac arrest was longer in the group of 1-min SCAC group than in the 30-s SCAC group or without SCAC (19.8 versus 11.45 versus 3.87 min, respectively, P < 0.001). The success rate of ORLT was higher in the SCAC group than in the group without SCAC (85% versus 15%, respectively, P < 0.001).
  
  
  CONCLUSIONS
  SCAC can effectively increase the success rate of ORLT by increasing the tolerable time during the anhepatic phase. The reason for this is the avoidance of hypovolumic cardiac arrest during the anhepatic phase.
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University School of Medicine, Taipei, Taiwan. csliu@vghtpe.gov.tw
authors.forename: Chinsu
authors.initials: C
authors.lastname: Liu
authors.forename: Hsin-Lin
authors.initials: HL
authors.lastname: Tsai
authors.forename: Taiwai
authors.initials: T
authors.lastname: Chin
authors.forename: Che-Chuan
authors.initials: CC
authors.lastname: Loong
authors.forename: Cheng-Yuan
authors.initials: CY
authors.lastname: Hsia
authors.forename: Choufu
authors.initials: C
authors.lastname: Wei
mesh_terms: D000818:Animals; D001012:Aorta, Abdominal; D002303:Cardiac Output, Low / Q000517:prevention & control*; D002445:Celiac Artery; D006323:Heart Arrest / Q000517:prevention & control; D006499:Hepatic Artery; D007431:Intraoperative Complications / Q000517:prevention & control*; D008102:Liver Circulation; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley; D013525:Surgical Instruments; D013997:Time Factors; D014682:Vena Cava, Inferior