Effect of Partial Portal Arterialization on Graft Survival in Experimental Liver Transplantation.
- Author:
Chang Hyun YOO
1
;
Dae Sik RIM
;
Jong Min KIM
Author Information
1. Department of Surgery, Kosin University College of Medicine, Pusan, Korea. microsur@ns.kosinmed.or.kr
- Publication Type:Original Article
- Keywords:
Experimental liver transplantation;
Portal arterialization
- MeSH:
Aorta;
Graft Survival*;
Liver Transplantation*;
Liver*;
Models, Animal;
Perfusion;
Portacaval Shunt, Surgical;
Portal Vein;
Transplants*;
Vena Cava, Inferior
- From:The Journal of the Korean Society for Transplantation
2000;14(1):75-80
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: In liver transplantation, low portal perfusion pressure may result in underperfusion of grafts and be the cause of primary nonfunction. Partial arterialization of portal vein could preserve graft perfusion. Up till now, there have been several clinical cases of temporary or permanent portal arterialization in liver transplantation. METHODS: In this study, we designed rat model for evaluating the effect of portal arterialization to improve survival of the under-perfused graft. Partial heterotopic non-regenerative liver transplantation was used with portal inflow only from inferior vena cava, which is known as portal under-perfusing liver transplantation model. Partial portal arterialization was performed by fenestration of the common wall between the IVC and the aorta through venotomy which was made for portacaval anastomosis. RESULTS: Immediate after arterialization, satisfactory macroscopic and duplex ultrasonographic liver perfusion were seen and the arterialized-graft survival was significantly improved to 95% (19/20) vs. 35% (7/20) of nonarterialized grafts. At 2-week after transplantation, the arterialized liver graft was atrophied showed normal gross appearance. The histopathologic examination with light microscope revealed no significant pathologic abnormality. CONCLUSION: Partial portal arteria;ization improved graft-survival of the under-perfusing liver grafts significantly and not affects the histologic hepatic structure adversely.
