Effect on Regenerating Capacity of Transplanted Liver by Arterialized Native Liver in Auxiliary Heterotopic Liver Transplantation in Pig.
- Author:
Hyuk Joon LEE
1
;
Hye Rin ROH
;
Kyung Suk SUH
;
Kuhn Uk LEE
Author Information
1. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. kssuh@plaza.snu.ac.kr
- Publication Type:Original Article
- Keywords:
Auxiliary heterotopic liver transplantation;
Graft liver;
Liver regeneration;
Pig
- MeSH:
Aorta;
Female;
Hemodynamics;
Hepatectomy;
Hepatic Artery;
Hepatic Veins;
Humans;
Kidney;
Liver Diseases;
Liver Function Tests;
Liver Regeneration;
Liver Transplantation*;
Liver*;
Models, Animal;
Physiology;
Portal Vein;
Proliferating Cell Nuclear Antigen;
Regeneration;
Renal Artery;
Renal Veins;
Swine;
Tissue Donors;
Transplants;
Vena Cava, Inferior;
Weights and Measures
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
2002;6(1):20-25
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Auxiliary liver transplantation means a procedure in which part of the native liver is left in situ. In this method, it has been suggested that blocking of portal flow to the native liver (arterialized liver) could potentiate the regeneration of the graft liver. In this study, we evaluate the effect on regeneration capacity of graft liver by blocking the portal flow to the native liver in auxiliary heterotopic liver transplantation in pig. METHODS: Female pigs weighing 25 kg and 30 kg were used as the donor and the recipient for liver transplantation, respectively. After total hepatectomy in the donor pig, graft liver was placed inferior to right liver and superior to right kidney of the recipient. The donor's hepatic vein was anastomosed to infrahepatic inferior vena cava superior to renal vein. The portal vein of the recipient was divided at the hilum and anastomosed with donor's portal vein. The donor's hepatic artery was anastomosed to the aorta below the renal artery. After 1, 3, 5, 7, 15th postoperative days, the weights of native and graft liver, proliferative cell nuclear antigen (PCNA) indices of both livers, and liver function test were checked. RESULTS: During the procedure, hemodynamic status was stable without using venovenous bypass. There was no postoperative death and no severe deterioration of hepatic function. During 5th and 15th postoperative days, PCNA indices of graft liver (40~60%) were higher than those of native liver (30%). The weight of graft liver was increased more than 80% of preoperative value on day 7 and 15. CONCLUSION: By arterialization of the native liver, the regeneration of the small graft liver could be accomplished smoothly without metabolic burden. This animal model is useful for studying graft liver physiology of liver transplantation in preclinical setting. With this study, the first case of auxiliary partial orthotopic liver transplantation was performed successfully in the patients who suffered from metabolic liver disease.
