Improvement of microsurgical techniques in orthotopic rat liver transplantation.
BACKGROUND
Because of the limited tolerance to portal venous clamping, the model of liver transplantation in rats represents a difficult task, which requires a great proportion of experience. Since techniques that include the introduction of an artificial stent increase the risk of thrombosis, it was our goal to modify the classical vascular hand-sewn venous anastomosis technique by using a modified end-to-end knotless procedure.


METHODS
Seventy-two animals were randomly assigned to 1 of 2 experimental groups, which differed by the technique for the 3 venous anastomoses (supra- and infrahepatic vena cava, portal vein). Group 1 comprised the established suturing technique for rat liver transplantation, whereas all venous anastomosis of the second group were performed using our modified technique.


RESULTS
With our method, average anhepatic time could be significantly reduced from 14 min 10 s (+/-100 s) to 11 min 40 s (+/-60 s) (P < 0.001). Kaplan-Meier survival rates demonstrated a better 7-d survival for the knotless (94%) compared to the classic technique (83%) (not significant, P = 0.137). Biliary complications were low in both groups but tended to be higher in the classical group.


CONCLUSIONS
Our modified knotless anastomosis proves to be equally safe in regard to complications, improves timing, and provides excellent results in the model of orthotopic rat liver transplantation.
Ariyakhagorn
Veeravorn
V
Department of Surgery, Chiangmai University, Chiangmai, Thailand. veeravorn.ariyakhagorn@charite.de
Schmitz
Volker
V
Olschewski
Peter
P
Polenz
Dietrich
D
Boas-Knoop
Sabine
S
Neumann
Ulf
U
Puhl
Gero
G
D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods*; D000818:Animals; D006085:Graft Survival; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods*; D051381:Rats; D017208:Rats, Wistar; D013997:Time Factors