A novel technique for rat liver transplantation using Quick Linker system: a preliminary result.
BACKGROUND
The clinical success of liver transplantation is founded upon years of experimental research. Since Kamada and colleagues developed the "two-cuff" technique, the rat has become the best model for extensive investigations. Although the Kamada technique is technically complex and not easy to master, it is still the mainstay of orthotopic liver transplantation in rodents. We have developed a modified three-cuff version of this technique that facilitates anastomosis and markedly reduces warm ischemia time.


METHODS
The new technique involves a set of five microinstruments (the Quick-Linker system) designed and manufactured by our group. It was tested in male Lewis rats (group 1, donors n = 10, recipients n = 10). The graft was explanted as usual and standard cuffs were attached to the portal vein and the supra- and infrahepatic vena cavae. Corresponding vessels in the recipient were isolated, and Quicker-Linker holding rings were attached to each. The vessels were then clamped and the native organ removed. Once the graft was positioned in the recipient's abdomen, the holding rings attached to the recipient vessels and the cuffs applied to graft vessels were automatically aligned and joined with the aid of a special alignment tool.


RESULTS
Warm ischemia times were always inferior to 6 minutes. Survival at postoperative day 10 was 80%. Liver function was well preserved in all of the surviving rats.


CONCLUSIONS
The Quick-Linker technique significantly shortens warm ischemia time and allows rapid anastomosis that is relatively independent of operator skill. It can be considered a reliable option for microsurgeons looking for quick results and high success rates.
Oldani
Graziano
G
University of Pavia, Department of Surgical Sciences, General Surgery and Laboratory of Experimental Surgery, Pavia, Italy.
Maestri
Marcello
M
Gaspari
Annalisa
A
Lillo
Ettore
E
Angelastri
Giacomo
G
Lenti
Luca Matteo
LM
Rademacher
Johannes
J
Alessiani
Mario
M
Dionigi
Paolo
P
D000714:Anastomosis, Surgical; D000818:Animals; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D023421:Models, Animal; D051381:Rats; D011917:Rats, Inbred Lew; D014682:Vena Cava, Inferior / Q000601:surgery*; D052096:Warm Ischemia