title: Hepatic artery reconstruction prevents ischemic graft injury, inhibits graft rejection, and mediates long-term graft acceptance in rat liver transplantation.
abstract: BACKGROUND
  Hepatic artery (HA) reconstruction is performed in the clinical liver transplantation.
  
  
  METHODS
  We assessed the importance of HA reconstruction in the success of liver transplantation. Orthotopic liver transplantation was performed without immunosspression from Lewis (RT1l) to Lewis rats (syngeneic transplantation) as well as Lewis to BN (RT1n) rats (allogeneic transplantation) with or without HA reconstruction. We examined graft function, pathology, and mRNA levels using DNA arrays in both arterialized and nonarterialized liver grafts.
  
  
  RESULTS
  In Lewis-to-Lewis syngeneic grafts, both the arterialized and nonarterialized grafts survived >120 days with normal graft function. lnfiltration of CD3(+) T cells and CD68(+) macrophages, marked bile duct proliferation with apoptotic epithelial cells, and expansion and increasing fibrosis of portal areas were evident in the nonarterialized grafts at day 120, although preservation of architecture was noted in the arterialized grafts. DNA array analysis of nonarterialized syngeneic grafts demonstrated the upregulation of mRNA of cell death-related proteins, cell cycle-related proteins, and inflammation-related proteins than those in arterialized grafts. Moreover, the arterialized Lewis-to-BN allogeneic grafts could survive for a long time with less severe graft dysfunction than those in non-arterialized allogeneic grafts.
  
  
  CONCLUSIONS
  HA reconstruction in liver transplantation inhibited hypoxic injury and subsequent inflammation and bile duct proliferation, prevented the augmentation of T-cell-and antibody-mediated rejection, and mediated long-term graft acceptance. HA reconstruction is essential factor in the success of liver transplantation.
authors.affiliation: Department of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan. ashimizu@nms.ac.jp
authors.forename: E
authors.initials: E
authors.lastname: Ishii
authors.forename: A
authors.initials: A
authors.lastname: Shimizu
authors.forename: N
authors.initials: N
authors.lastname: Kuwahara
authors.forename: G
authors.initials: G
authors.lastname: Kanzaki
authors.forename: S
authors.initials: S
authors.lastname: Higo
authors.forename: Y
authors.initials: Y
authors.lastname: Kajimoto
authors.forename: T
authors.initials: T
authors.lastname: Arai
authors.forename: S
authors.initials: S
authors.lastname: Nagasaka
authors.forename: Y
authors.initials: Y
authors.lastname: Masuda
authors.forename: Y
authors.initials: Y
authors.lastname: Fukuda
mesh_terms: D000818:Animals; D006084:Graft Rejection / Q000517:prevention & control*; D006085:Graft Survival; D006499:Hepatic Artery / Q000601:surgery*; D007511:Ischemia / Q000517:prevention & control*; D008099:Liver / Q000098:blood supply*; D016031:Liver Transplantation; D051381:Rats; D011917:Rats, Inbred Lew